Provider Demographics
NPI:1720006901
Name:BOYST, PATRICIA L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:L
Last Name:BOYST
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 1:324 E ANTIETAM ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5754
Mailing Address - Country:US
Mailing Address - Phone:301-791-6666
Mailing Address - Fax:301-791-4549
Practice Address - Street 1:324 E ANTIETAM ST
Practice Address - Street 2:SUITE 301
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5754
Practice Address - Country:US
Practice Address - Phone:301-791-6666
Practice Address - Fax:301-791-4549
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR090893363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD149091500Medicaid