Provider Demographics
NPI:1083989834
Name:BOYD, JENNIFER ARLEEN (RN)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ARLEEN
Last Name:BOYD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 AVENUE C
Mailing Address - Street 2:ROOM 352
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4514
Mailing Address - Country:US
Mailing Address - Phone:718-853-6269
Mailing Address - Fax:
Practice Address - Street 1:202 AVENUE C
Practice Address - Street 2:ROOM 352
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4514
Practice Address - Country:US
Practice Address - Phone:718-438-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4520981163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool