Stacey Boyd, LPN

Individual provider Active NPI Licensed Practical Nurse · Rapid City, SD

NPI 1154092740 · NPPES record last updated Sep 23, 2021

Key facts

NPI
1154092740
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
P009033 (SD)
Practice address
3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone
(605) 355-2500
Fax
(605) 355-2512
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P009033SDMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P009033 SD Yes

Addresses

Primary practice location

3200 Canyon Lake Dr
Rapid City, SD 57702-8114

Mailing address

3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone (605) 355-2500

Other providers in Rapid City, SD

All providers in Rapid City, SD · Licensed Practical Nurse in South Dakota

Sources for this page

Verify at the official NPI Registry.