Provider Demographics
NPI:1093848210
Name:BOYD, LAURA M (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:BOYD
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 894
Mailing Address - Street 2:
Mailing Address - City:MEADOW VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:95722-0894
Mailing Address - Country:US
Mailing Address - Phone:916-787-8800
Mailing Address - Fax:916-787-8857
Practice Address - Street 1:11533 C AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2703
Practice Address - Country:US
Practice Address - Phone:530-889-7254
Practice Address - Fax:530-889-7275
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA492226163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult