Provider Demographics
NPI:1376208355
Name:BOYLAND, REBEKAH (PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:REBEKAH
Middle Name:
Last Name:BOYLAND
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 MADISON AVE APT 410
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2592
Mailing Address - Country:US
Mailing Address - Phone:901-628-5852
Mailing Address - Fax:
Practice Address - Street 1:1475 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-6961
Practice Address - Country:US
Practice Address - Phone:270-813-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018797363LP0808X
TN30429363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health