Provider Demographics
NPI:1922815026
Name:BOYER, KAITLYN KRISTINA (PMHNP)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:KRISTINA
Last Name:BOYER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-1320
Mailing Address - Country:US
Mailing Address - Phone:860-455-8655
Mailing Address - Fax:
Practice Address - Street 1:THE MIRIAM HOSPITAL
Practice Address - Street 2:164 SUMMIT AVE
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906
Practice Address - Country:US
Practice Address - Phone:401-793-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN04343363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health