Provider Demographics
NPI:1407523855
Name:TAYLOR BOYETTE, DENISE A (APRN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:TAYLOR BOYETTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 N US HWY 441
Practice Address - Street 2:BUILDING 500, SUITE 540
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-8987
Practice Address - Country:US
Practice Address - Phone:352-753-9777
Practice Address - Fax:866-446-1888
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014900363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily