Barbara A. Boyd, P233404

Individual provider Active NPI Licensed Practical Nurse · Laurel, MS

NPI 1720293145 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1720293145
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
P233404 (MS)
Practice address
901 S 14TH Ave
Laurel, MS 39440-4920
Phone
(601) 422-0655
Fax
(601) 422-0655
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

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
P233404MSMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P233404 MS Yes

Addresses

Primary practice location

901 S 14TH Ave
Laurel, MS 39440-4920

Mailing address

901 S 14TH Ave
Laurel, MS 39440-4920
Phone (601) 422-0655

Other identifiers

IdentifierTypeStateIssuer
00770245MedicaidMS

Other providers in Laurel, MS

All providers in Laurel, MS · Licensed Practical Nurse in Mississippi

Sources for this page

Verify at the official NPI Registry.