Provider Demographics
NPI:1194419655
Name:BOYLE, LAURIN CHELSI (FNP)
Entity type:Individual
Prefix:
First Name:LAURIN
Middle Name:CHELSI
Last Name:BOYLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S TONTO ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5968
Mailing Address - Country:US
Mailing Address - Phone:757-202-1348
Mailing Address - Fax:
Practice Address - Street 1:9163 W UNION HILLS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-8186
Practice Address - Country:US
Practice Address - Phone:757-202-1348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ222894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily