Provider Demographics
NPI:1679589162
Name:BOYD, JULIA ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:BOYD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 COTTAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-4210
Mailing Address - Country:US
Mailing Address - Phone:251-666-2439
Mailing Address - Fax:251-666-3166
Practice Address - Street 1:5621 COTTAGE HILL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4210
Practice Address - Country:US
Practice Address - Phone:251-666-2439
Practice Address - Fax:251-666-3166
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-089709363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S95100Medicare UPIN