Healthcare Provider Details

I. General information

NPI: 1609648120
Provider Name (Legal Business Name): COYERON BOYKINS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 INDEPENDENCE PKWY STE 110
CHESAPEAKE VA
23320-5114
US

IV. Provider business mailing address

661 INDEPENDENCE PKWY STE 110
CHESAPEAKE VA
23320-5114
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-8221
  • Fax: 757-312-8382
Mailing address:
  • Phone: 757-312-8221
  • Fax: 757-312-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024188596
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: