Provider Demographics
NPI:1407005085
Name:BOYD, AMBER (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 GORDON ST
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-1519
Mailing Address - Country:US
Mailing Address - Phone:770-537-1234
Mailing Address - Fax:770-537-1237
Practice Address - Street 1:107 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4335
Practice Address - Country:US
Practice Address - Phone:678-390-7070
Practice Address - Fax:678-390-7071
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN149651363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics