Jared Andrew Boyle
Nutritionist in Wausau, WI. Individual provider (NPI-1).
NPI number1235798554
StatusActive
Last updated in NPPESJun 10, 2019
Details
- NPI
- 1235798554
- Entity type
- Individual (NPI-1)
- Name
- Jared Andrew Boyle
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2019
- Last updated
- Jun 10, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133N00000X | Nutritionist | – | – | Yes |
Practice location
4048 Crestwood DrWausau, WI 54403-8122
Phone 715-370-5646
Mailing address
4048 Crestwood DrWausau, WI 54403-8122
Phone 715-370-5646
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