Provider Demographics
NPI:1043988561
Name:BOYLE, KERITH (MSN, RN)
Entity type:Individual
Prefix:
First Name:KERITH
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1015
Mailing Address - Country:US
Mailing Address - Phone:732-241-1015
Mailing Address - Fax:
Practice Address - Street 1:17 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1015
Practice Address - Country:US
Practice Address - Phone:732-241-1015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14289500163W00000X
291U00000X
NJ26NJ01481900363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No291U00000XLaboratoriesClinical Medical Laboratory