Provider Demographics
NPI:1144517889
Name:BOYCE, SUSAN C (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:BOYCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11318
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-5318
Mailing Address - Country:US
Mailing Address - Phone:206-484-4343
Mailing Address - Fax:
Practice Address - Street 1:709 W 9TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-796-4300
Practice Address - Fax:907-796-4301
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK9683163W00000X
WA57534163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse