Healthcare Provider Details

I. General information

NPI: 1730340175
Provider Name (Legal Business Name): ELIZABETH ANN BOYKIN FNP,BS,MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 07/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 ADAIR AVE
ZANESVILLE OH
43701-2836
US

IV. Provider business mailing address

859 N MAIN ST
MALTA OH
43758-9007
US

V. Phone/Fax

Practice location:
  • Phone: 740-891-9000
  • Fax: 740-891-9001
Mailing address:
  • Phone: 740-962-6111
  • Fax: 740-962-1657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberNP 10039
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.10039-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: