Provider Demographics
NPI:1710548706
Name:ALMY-BOYLAN, MONICA (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ALMY-BOYLAN
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 1:2022 KELLE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-8708
Mailing Address - Country:US
Mailing Address - Phone:219-364-4004
Mailing Address - Fax:
Practice Address - Street 1:601 W KIEFFER RD
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9599
Practice Address - Country:US
Practice Address - Phone:219-878-3217
Practice Address - Fax:219-814-4788
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.403144363LF0000X
IN71009799A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily