Healthcare Provider Details

I. General information

NPI: 1336606060
Provider Name (Legal Business Name): EUNICE CARREEN BOYD-GANT DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EUNICE CARREEN BOYD-MASSAQUOI

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 S QUEEN ST STE 102
DOVER DE
19904-3506
US

IV. Provider business mailing address

1340 MIDDLEFORD ROAD STE 401
SEAFORD DE
19973-3665
US

V. Phone/Fax

Practice location:
  • Phone: 302-487-8885
  • Fax:
Mailing address:
  • Phone: 800-818-8680
  • Fax: 866-229-0237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001240
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0016090-PMHNP
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLG-0001240-NP
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: