Provider Demographics
NPI:1306023205
Name:BOYD, JONNIE LUCY E (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JONNIE LUCY
Middle Name:E
Last Name:BOYD
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:J. LUCY
Other - Middle Name:
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9191 WOOD LN
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-3159
Mailing Address - Country:US
Mailing Address - Phone:423-843-1331
Mailing Address - Fax:
Practice Address - Street 1:9191 WOOD LN
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-3159
Practice Address - Country:US
Practice Address - Phone:423-843-1331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000130337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse