Provider Demographics
NPI:1811411952
Name:BOYD, ROBERT JAMES (RN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:BOYD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 E 139TH PL
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-7248
Mailing Address - Country:US
Mailing Address - Phone:303-475-7654
Mailing Address - Fax:
Practice Address - Street 1:2451 E 139TH PL
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-7248
Practice Address - Country:US
Practice Address - Phone:303-475-7654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0185052163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CORN.0185052OtherCOLORADO DORA