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Individual

MRS. TATYANA VICTOROVNA BOYTIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
3100 SPRING FOREST RD STE 130, RALEIGH, NC 27616-2880
(919) 873-9533

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
242908
NC
163W00000X
Registered Nurse
RN.350171
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
105657
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
105657
CRNA LICENSE
NC
01
242908
RN LICENSE
NC
Enumeration date
02/03/2015
Last updated
12/19/2025
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