Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | CNP201461 | ME |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 2015003124 | MO |
NPI | 1033601356 |
---|---|
Provider Name | Kimberly Marie Boyer |
First Address | Barnhart, MO 63012-2342 |
Second Address | Farmington, ME 04938-6144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2018 |
Last Update Date | 13/04/2021 |