Provider Demographics
NPI:1447493036
Name:BOYER, MICHELLE SOVERN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:SOVERN
Last Name:BOYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7792 MISTY SHORE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-9645
Mailing Address - Country:US
Mailing Address - Phone:937-885-7163
Mailing Address - Fax:937-885-7193
Practice Address - Street 1:1110 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45419-2911
Practice Address - Country:US
Practice Address - Phone:937-885-7163
Practice Address - Fax:937-567-0670
Is Sole Proprietor?:No
Enumeration Date:2009-04-12
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002895363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical