Provider Demographics
NPI:1013250273
Name:BOYD, JANICE YVETTE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:YVETTE
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:YVETTE
Other - Last Name:BOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3030
Mailing Address - Country:US
Mailing Address - Phone:404-613-1418
Mailing Address - Fax:404-730-1499
Practice Address - Street 1:99 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3030
Practice Address - Country:US
Practice Address - Phone:404-613-1418
Practice Address - Fax:404-730-1499
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR083368163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse