Provider Demographics
NPI:1083268502
Name:BOYLE, ERIN TERESA (NP-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:TERESA
Last Name:BOYLE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 GLENRIDGE DR STE T200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5873
Mailing Address - Country:US
Mailing Address - Phone:404-256-5428
Mailing Address - Fax:
Practice Address - Street 1:5730 GLENRIDGE DR STE T200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5873
Practice Address - Country:US
Practice Address - Phone:404-256-5428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN285868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily