Individual
GERILEY RAE BOYUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, RN
Contact information
Practice address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Mailing address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R34339
ND
164W00000X
Licensed Practical Nurse
L12141
ND
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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