Provider Demographics
NPI:1871145896
Name:BOYD, MICHELLE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:BOYD
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:180 FORD RD
Mailing Address - Street 2:
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845-2009
Mailing Address - Country:US
Mailing Address - Phone:541-575-0404
Mailing Address - Fax:541-575-1124
Practice Address - Street 1:180 FORD RD
Practice Address - Street 2:
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845-2009
Practice Address - Country:US
Practice Address - Phone:541-575-0404
Practice Address - Fax:541-575-1124
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60974078363L00000X, 363LF0000X
OR202214409NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner