Provider Demographics
NPI:1124761184
Name:BOYD, SIEARIA MONAY
Entity type:Individual
Prefix:
First Name:SIEARIA
Middle Name:MONAY
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W BELVOIR RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-1188
Mailing Address - Country:US
Mailing Address - Phone:252-902-4052
Mailing Address - Fax:
Practice Address - Street 1:620 W BELVOIR RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1188
Practice Address - Country:US
Practice Address - Phone:252-902-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2077809343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)