Individual
KATHLEEN O'CONNOR BOYD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
073987
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052461
—
NC
01
—
P00302028
RR MEDICARE
—
Enumeration date
08/31/2006
Last updated
10/28/2020
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