Provider Demographics
NPI:1902655749
Name:BOYD, SHAWN DALE (FNP-BC)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:DALE
Last Name:BOYD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24743 DICKENSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:HAYSI
Mailing Address - State:VA
Mailing Address - Zip Code:24256
Mailing Address - Country:US
Mailing Address - Phone:276-865-7811
Mailing Address - Fax:
Practice Address - Street 1:24743 DICKENSON HIGHWAY
Practice Address - Street 2:
Practice Address - City:HAYSI
Practice Address - State:VA
Practice Address - Zip Code:24256
Practice Address - Country:US
Practice Address - Phone:276-865-7811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001281352163W00000X
KY4022840363LF0000X
VA0024190300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse