Provider Demographics
NPI:1760775423
Name:BOYD, TANGELA LYNN (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:TANGELA
Middle Name:LYNN
Last Name:BOYD
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10429 DUNCANNON TRL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-1200
Mailing Address - Country:US
Mailing Address - Phone:334-593-5562
Mailing Address - Fax:334-593-5041
Practice Address - Street 1:10429 DUNCANNON TRL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-1200
Practice Address - Country:US
Practice Address - Phone:334-593-5562
Practice Address - Fax:334-593-5041
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11084489174N00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula