Provider Demographics
NPI:1932502705
Name:BOYD, KRISTIN ELAINE (CNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ELAINE
Last Name:BOYD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:ELAINE
Other - Last Name:PYKARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2760 PARKMAN RD NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-1635
Mailing Address - Country:US
Mailing Address - Phone:330-898-1723
Mailing Address - Fax:330-898-7596
Practice Address - Street 1:2760 PARKMAN RD NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-1635
Practice Address - Country:US
Practice Address - Phone:330-898-1723
Practice Address - Fax:330-898-7596
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16575363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology