Provider Demographics
NPI:1093434847
Name:BOYER, RICHARD E (APRN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:BOYER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:E
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:18222 E 49TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-7316
Mailing Address - Country:US
Mailing Address - Phone:918-261-8724
Mailing Address - Fax:
Practice Address - Street 1:7912 E 31ST CT STE 320
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1305
Practice Address - Country:US
Practice Address - Phone:918-496-8499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62647163WC0200X
OK212595363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine