Provider Demographics
NPI:1063292878
Name:BOYD, REBECCA S (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:BOYD
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8413
Mailing Address - Country:US
Mailing Address - Phone:303-668-6267
Mailing Address - Fax:
Practice Address - Street 1:351 DOGWOOD RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-8413
Practice Address - Country:US
Practice Address - Phone:303-668-6267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC329524163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse