Provider Demographics
NPI:1568540722
Name:BOYER, DAWN VYRELLE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:VYRELLE
Last Name:BOYER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:VYRELLE
Other - Last Name:SEWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1059 NEAL ST STE 101
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0946
Mailing Address - Country:US
Mailing Address - Phone:931-507-1212
Mailing Address - Fax:
Practice Address - Street 1:1059 NEAL ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-0946
Practice Address - Country:US
Practice Address - Phone:931-528-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2961952363L00000X, 363LP0200X
TNAPN0000024821363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL311903300Medicaid
Y090TZMedicare PIN
FL311903300Medicaid