Provider Demographics
NPI:1902131964
Name:BOYD, AMANDA M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:BOYD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12120 STATE ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-1840
Mailing Address - Country:US
Mailing Address - Phone:724-863-4362
Mailing Address - Fax:
Practice Address - Street 1:12120 STATE ROUTE 30
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-1840
Practice Address - Country:US
Practice Address - Phone:724-863-4362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053926363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant