Provider Demographics
NPI:1750941845
Name:BOISON, AMY SCHOENHOLZ
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:SCHOENHOLZ
Last Name:BOISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LOVE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6926
Mailing Address - Country:US
Mailing Address - Phone:203-246-7565
Mailing Address - Fax:
Practice Address - Street 1:6911 SHANNON WILLOW RD STE 400
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1350
Practice Address - Country:US
Practice Address - Phone:980-296-2211
Practice Address - Fax:984-235-1617
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC272653363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health