Individual
ELIZABETH N BOYUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14305 SOUTHCROSS DR W STE 110, BURNSVILLE, MN 55306-7011
(513) 401-0646
Mailing address
14305 SOUTHCROSS DR W STE 110, BURNSVILLE, MN 55306-7011
(651) 340-1064
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9778
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041654
PREFERRED ONE
—
01
—
507S6NE
BCBS
—
01
—
HP36291
PARTNERS HEALTH
—
Enumeration date
06/06/2006
Last updated
04/22/2025
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