Provider Demographics
NPI:1659913689
Name:BOYD, ROSEMARY ELLEN (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:ELLEN
Last Name:BOYD
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:ELLEN
Other - Last Name:LANDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN IBCLC
Mailing Address - Street 1:9012 HASKELL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3112
Mailing Address - Country:US
Mailing Address - Phone:971-282-3746
Mailing Address - Fax:
Practice Address - Street 1:9012 HASKELL AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3112
Practice Address - Country:US
Practice Address - Phone:971-282-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95062701163W00000X, 163WH0200X, 163WI0500X, 163WM0102X, 163WN0002X, 163WN0003X, 163WP0200X, 163WP1700X, 163WS0121X, 163WW0101X, 163WX0002X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk