Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | AP30007449 | WA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP30007449 | WA |
NPI | 1205860079 |
---|---|
Provider Name | Lorena G Boyd |
First Address | Wenatchee, WA 98801-2800 |
Second Address | East Wenatchee, WA 98802-6602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 28/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9649740 | (05) | WA |
Q72764 | (02) | WA |