Provider Demographics
NPI:1811373913
Name:BOYD, KATHY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:CALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:178 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4352
Mailing Address - Country:US
Mailing Address - Phone:603-332-1133
Mailing Address - Fax:
Practice Address - Street 1:821 TURNPIKE ROAD
Practice Address - Street 2:
Practice Address - City:NEW IPSWICH
Practice Address - State:NH
Practice Address - Zip Code:03071
Practice Address - Country:US
Practice Address - Phone:603-878-1092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH064883-23207QH0002X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3101718Medicaid