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Individual

SANDRA BOYLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.P. N. P.

Contact information

Practice address
3685 LAWRENCEVILLE HWY, SUITE 100, LAWRENCEVILLE, GA 30044-4107
(770) 921-7386
(770) 381-6013
Mailing address
3685 LAWRENCEVILLE HWY, SUITE 100, LAWRENCEVILLE, GA 30044-4107
(770) 921-7386
(770) 381-6013

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R091497
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00828033A
GA
05
00828033B
GA
Enumeration date
08/23/2006
Last updated
07/09/2007
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