Provider Demographics
NPI:1033839758
Name:BOYTE, COREY (RN, CCM)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:BOYTE
Suffix:
Gender:M
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5837 SYLVAN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1098
Mailing Address - Country:US
Mailing Address - Phone:419-490-2698
Mailing Address - Fax:888-838-0235
Practice Address - Street 1:5837 SYLVAN RIDGE DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1098
Practice Address - Country:US
Practice Address - Phone:419-490-6798
Practice Address - Fax:888-838-0235
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.402193163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty