Provider Demographics
NPI:1407629264
Name:BOYKIN, ASIA CORRINE
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:CORRINE
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASIA
Other - Middle Name:CORRINE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:133 COUNTY ROAD 372
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-8555
Mailing Address - Country:US
Mailing Address - Phone:870-318-8397
Mailing Address - Fax:
Practice Address - Street 1:133 COUNTY ROAD 372
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-8555
Practice Address - Country:US
Practice Address - Phone:870-318-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR226232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily