Provider Demographics
NPI:1205860079
Name:BOYD, LORENA G (ARNP)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:G
Last Name:BOYD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ORONDO AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2800
Mailing Address - Country:US
Mailing Address - Phone:509-662-6000
Mailing Address - Fax:509-664-4588
Practice Address - Street 1:900 EASTMONT AVE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-6602
Practice Address - Country:US
Practice Address - Phone:509-884-9000
Practice Address - Fax:509-884-9041
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00085738163WC1500X
WAAP30007449363LC1500X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9649740Medicaid
WA1205860079Medicaid
WA9649740Medicaid
WA9649740Medicaid
WAG8923676,G8923677Medicare PIN
WA1205860079Medicaid