Provider Demographics
NPI:1003052804
Name:BOYNTON, JENA PATRICE (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:PATRICE
Last Name:BOYNTON
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21321 E OCOTILLO RD
Mailing Address - Street 2:SUITE 127
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-5996
Mailing Address - Country:US
Mailing Address - Phone:480-888-7271
Mailing Address - Fax:480-888-7904
Practice Address - Street 1:21321 E OCOTILLO RD
Practice Address - Street 2:SUITE 127
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-5996
Practice Address - Country:US
Practice Address - Phone:480-888-7271
Practice Address - Fax:480-888-7904
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3239363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health