Provider Demographics
NPI:1528168630
Name:BOYD, MICHELE (CRNA)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3109
Mailing Address - Country:US
Mailing Address - Phone:603-589-1885
Mailing Address - Fax:
Practice Address - Street 1:168 KINSLEY ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3634
Practice Address - Country:US
Practice Address - Phone:603-882-1501
Practice Address - Fax:603-882-9747
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04200154367500000X
NH043721-23367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30343699Medicaid
NH40Y008421NH01OtherANTHEM BLUE SHIELD
NH40Y008421NH01OtherANTHEM BLUE SHIELD