Individual
MALLORY BOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP, RN
Contact information
Practice address
822 PINE ST, PHILADELPHIA, PA 19107-6187
(267) 519-0154
Mailing address
9 VIRGINIA AVE, HADDON TOWNSHIP, NJ 08108-2316
(856) 904-9753
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR22832300
NJ
163W00000X
Registered Nurse
RN685967
PA
363LF0000X
Family Nurse Practitioner
26NJ01457800
NJ
363LF0000X
Family Nurse Practitioner
Primary
SP027836
PA
Other
Enumeration date
01/20/2023
Last updated
07/18/2023
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