Provider Demographics
NPI:1174346316
Name:BOYD, AMELIA A (RN)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:A
Last Name:BOYD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7065 W SUGARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-6268
Mailing Address - Country:US
Mailing Address - Phone:702-449-8585
Mailing Address - Fax:
Practice Address - Street 1:7065 W SUGARWOOD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-6268
Practice Address - Country:US
Practice Address - Phone:702-449-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1651080163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse