Healthcare Provider Details

I. General information

NPI: 1922527985
Provider Name (Legal Business Name): MS. ANGELINE BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 08/20/2023
Certification Date: 08/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 EDEN WAY N, SUITE 604 STUDIO 22
CHESAPEAKE VA
23320-3074
US

IV. Provider business mailing address

829 QUEENS WAY
VIRGINIA BEACH VA
23454-3430
US

V. Phone/Fax

Practice location:
  • Phone: 757-219-2190
  • Fax:
Mailing address:
  • Phone: 757-692-0231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number1201097453
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: