Provider Demographics
NPI:1598420267
Name:BOYD, CRYSTAL DANIELLE (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:DANIELLE
Last Name:BOYD
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3643 STATE ROUTE 152
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:43944-7950
Mailing Address - Country:US
Mailing Address - Phone:740-457-6247
Mailing Address - Fax:
Practice Address - Street 1:3643 STATE ROUTE 152
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:OH
Practice Address - Zip Code:43944-7950
Practice Address - Country:US
Practice Address - Phone:740-457-6247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily