Provider Demographics
NPI:1518516541
Name:BOYD, KERA ELIZABETH
Entity Type:Individual
Prefix:
First Name:KERA
Middle Name:ELIZABETH
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17927 N PARKVIEW PL APT 3205
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2407
Mailing Address - Country:US
Mailing Address - Phone:605-206-1337
Mailing Address - Fax:
Practice Address - Street 1:9842 W SANDS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-3303
Practice Address - Country:US
Practice Address - Phone:623-243-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider