Provider Demographics
NPI:1851853311
Name:BOYD, SANDRA RENEE MORRIS (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:SANDRA RENEE
Middle Name:MORRIS
Last Name:BOYD
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:SANDRA RENEE
Other - Middle Name:MORRIS
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:BUSHLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79012-0067
Mailing Address - Country:US
Mailing Address - Phone:806-359-6802
Mailing Address - Fax:
Practice Address - Street 1:20001 WIND RIVER DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1682
Practice Address - Country:US
Practice Address - Phone:806-359-6802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily