Provider Demographics
NPI:1285925776
Name:MILLER-BOYLE, DIANNE KATHLEEN (APRN)
Entity type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:KATHLEEN
Last Name:MILLER-BOYLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 W HEFNER RD
Mailing Address - Street 2:B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-7618
Mailing Address - Country:US
Mailing Address - Phone:405-749-0800
Mailing Address - Fax:
Practice Address - Street 1:2208 W HEFNER RD
Practice Address - Street 2:B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-7618
Practice Address - Country:US
Practice Address - Phone:405-749-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0030636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily