Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2003013131 | MO |
Y | 208000000X | Pediatrician | D69298 | MD |
N | 208000000X | Pediatrician | MD042863 | DC |
N | 2080P0214X | Pediatric Pulmonologist | 2003013131 | MO |
NPI | 1285809640 |
---|---|
Provider Name | Jessica Henderson Boyd |
First Address | Washington, DC 20003-3326 |
Second Address | Washington, DC 20003-3326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 12/11/2019 |