Provider Demographics
NPI:1255628665
Name:BOYD, DORRUTH (FNP-BC)
Entity type:Individual
Prefix:
First Name:DORRUTH
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DORRUTH
Other - Middle Name:
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5135 MENEFEE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-1432
Mailing Address - Country:US
Mailing Address - Phone:214-275-2062
Mailing Address - Fax:214-381-9064
Practice Address - Street 1:5135 MENEFEE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-1432
Practice Address - Country:US
Practice Address - Phone:214-275-2062
Practice Address - Fax:214-381-9064
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX513575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily