Provider Demographics
NPI:1407831282
Name:BOYD, NANCY A (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
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 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-328-8371
Mailing Address - Fax:385-328-1519
Practice Address - Street 1:105 WHITEHALL DR
Practice Address - Street 2:SUITE 109-114
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5269
Practice Address - Country:US
Practice Address - Phone:904-829-2782
Practice Address - Fax:904-829-2494
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1098192163W00000X, 363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301748601Medicaid
FLY5910OtherNETWORK BLUE PPS
FL080193404OtherRR MEDICARE
FL1934541OtherUNITED HEALTH CARE
FL149767OtherHEALTHEASE
FL301748600Medicaid
FL080193404OtherRR MEDICARE
FL301748601Medicaid
FLY5910Medicare PIN