Basic Information
| Provider Information | |||||||||
| NPI: | 1114187853 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOYLE | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3850 N GRANT AVENUE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805381618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706245170 | ||||||||
| FaxNumber: | 9706697521 | ||||||||
| Practice Location | |||||||||
| Address1: | 3850 N GRANT AVE | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805388431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706245170 | ||||||||
| FaxNumber: | 9706697521 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2008 | ||||||||
| LastUpdateDate: | 04/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 5693 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 75737540 | 05 | CO | MEDICAID | 019625 | 01 | CO | KAISER COMMERCIAL NUMBER | OTHER |