Provider Demographics
NPI:1114607694
Name:BOYD, TELZORA ANESE
Entity Type:Individual
Prefix:
First Name:TELZORA
Middle Name:ANESE
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 WHEELER RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-6035
Mailing Address - Country:US
Mailing Address - Phone:202-277-2350
Mailing Address - Fax:
Practice Address - Street 1:900 VARNEY ST SE APT 113
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4314
Practice Address - Country:US
Practice Address - Phone:202-340-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant