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General NPI Number Information
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NPI Number | 1417714460
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Entity Type | Individual
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Provider Name | SHATASIA C BOYNTON
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Gender | Female
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 5683 EARNINGS DR
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City | COLUMBUS
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State | OH
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Zip | 43232-7431
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Country | US
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Telephone | 614-270-4573
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Fax |
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Provider Business Mailing Address
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Address Line | 5683 EARNINGS DR
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City | COLUMBUS
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State | OH
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Zip | 43232-7431
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Country | US
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Telephone | 614-270-4573
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 323259370615
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License Number State | OH
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