Provider Demographics
NPI:1447640321
Name:BOYD, AMANDA (CRNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 LAKESHORE DR
Mailing Address - Street 2:STE 170
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6729
Mailing Address - Country:US
Mailing Address - Phone:205-397-4783
Mailing Address - Fax:205-868-6696
Practice Address - Street 1:2200 LAKESHORE DR
Practice Address - Street 2:STE 150
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-8803
Practice Address - Country:US
Practice Address - Phone:205-871-6926
Practice Address - Fax:205-871-7981
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-112941363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health