Provider Demographics
NPI:1780175745
Name:BOYD, LISA E
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:E
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ELAINE
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8810 TAMARACK LN
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9666
Mailing Address - Country:US
Mailing Address - Phone:734-945-7600
Mailing Address - Fax:
Practice Address - Street 1:8810 TAMARACK LN
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9666
Practice Address - Country:US
Practice Address - Phone:734-945-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health