Individual
MICHELLE E BOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 QUINCY AVE, MOSES TAYLOR HOSPITAL, SCRANTON, PA 18510-1724
(570) 770-5000
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN501677
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099931
MEDICARE
PA
05
—
1016896150001
—
PA
Enumeration date
01/25/2006
Last updated
02/04/2022
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