Provider Demographics
NPI:1033467527
Name:BOYD, PAMELA AMELIA (MS, APRN, FNP-C)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:AMELIA
Last Name:BOYD
Suffix:
Gender:F
Credentials:MS, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2594 LOGANVILLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-7848
Mailing Address - Country:US
Mailing Address - Phone:678-225-4999
Mailing Address - Fax:678-225-5546
Practice Address - Street 1:2594 LOGANVILLE HWY STE 101
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-7848
Practice Address - Country:US
Practice Address - Phone:678-225-4999
Practice Address - Fax:678-225-5546
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN060082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily