Provider Demographics
NPI:1689141699
Name:BOYD, CORINNE NICOLLE
Entity Type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:NICOLLE
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 MILLBURY ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-3217
Mailing Address - Country:US
Mailing Address - Phone:123-135-7122
Mailing Address - Fax:
Practice Address - Street 1:152 MILLBURY ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-3217
Practice Address - Country:US
Practice Address - Phone:123-135-7122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program