Provider Demographics
NPI:1912711003
Name:BOYLES, JORDYN LEIGH
Entity type:Individual
Prefix:
First Name:JORDYN
Middle Name:LEIGH
Last Name:BOYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68981-0011
Mailing Address - Country:US
Mailing Address - Phone:308-870-4487
Mailing Address - Fax:
Practice Address - Street 1:1318 CRANE AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2825
Practice Address - Country:US
Practice Address - Phone:308-750-2198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker