Provider Demographics
NPI:1851953574
Name:BOYD-GANTT, YOLANDA FELITA (NP)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:FELITA
Last Name:BOYD-GANTT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100 DEPT#394
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:941-300-4440
Mailing Address - Fax:941-404-1760
Practice Address - Street 1:1911 HAMPTON ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3535
Practice Address - Country:US
Practice Address - Phone:803-849-8430
Practice Address - Fax:803-445-1138
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22993207QG0300X, 363LP2300X
FLAPRN11016703363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine