Aleza Marie Boyette | Hattiesburg, MS • PECOS Search

Aleza Marie Boyette

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

5192 Old Highway 11, Hattiesburg, MS 39402-6222

(601) 268-0929 (601) 264-0929

PECOS Enrollment

Based on the most recent information from CMS, provider Aleza Marie Boyette does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1831496603
Provider Type
Individual
Full Name
Boyette, Aleza Marie
Title
Mrs.
Credential
NP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/14/2011
Last Updated
2/14/2011

Contact Information

Practice Location

5192 Old Highway 11, Hattiesburg, MS 39402-6222

Unlisted Fax

Mailing Location

133 Mayfair Rd, Hattiesburg, MS 39402-1464

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R876535 Mississippi