Provider Demographics
NPI:1760098305
Name:BOYCE, KERRY M (RN, FNP)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:M
Last Name:BOYCE
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 FREEPORT LOOP APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-2312
Mailing Address - Country:US
Mailing Address - Phone:917-482-6349
Mailing Address - Fax:
Practice Address - Street 1:461 PARK AVE S FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7567
Practice Address - Country:US
Practice Address - Phone:212-989-9828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY572820163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse