Provider Demographics
NPI:1043454853
Name:BOYD, HOLLY MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MARIE
Last Name:BOYD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:445 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5680
Mailing Address - Country:US
Mailing Address - Phone:352-666-1200
Mailing Address - Fax:352-688-5556
Practice Address - Street 1:20615 AMBERFIELD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-4301
Practice Address - Country:US
Practice Address - Phone:813-949-2950
Practice Address - Fax:813-949-2924
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9220930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0197LOtherMEDICARE PTAN NUMBER