Provider Demographics
NPI:1619559382
Name:BOYD, MELISSA (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 HIGHWAY 286
Mailing Address - Street 2:UNIT B
Mailing Address - City:ETON
Mailing Address - State:GA
Mailing Address - Zip Code:30724
Mailing Address - Country:US
Mailing Address - Phone:706-971-3757
Mailing Address - Fax:706-971-3393
Practice Address - Street 1:79 HIGHWAY 286 UNIT B
Practice Address - Street 2:
Practice Address - City:ETON
Practice Address - State:GA
Practice Address - Zip Code:30705-6501
Practice Address - Country:US
Practice Address - Phone:706-971-3757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANCO-000003363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health