MEDICARE: CHRISTY BOYKIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	0001080	OH

General Provider Information

NPI Number	:	1033786967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY BOYKIN

Provider Business Mailing Address
First Line	:	2391 S 6TH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-2980
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1067 SULLIVANT AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43223-1437
Country	:	US
Telephone Number	:	614-349-1154
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	06/09/2021

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Directions to “ CHRISTY BOYKIN ” Practice Location

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