Provider Demographics
NPI:1508572280
Name:BOYNTON, KATINA L (RN)
Entity Type:Individual
Prefix:
First Name:KATINA
Middle Name:L
Last Name:BOYNTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 SE RANDALL CT APT A
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-2076
Mailing Address - Country:US
Mailing Address - Phone:561-396-6044
Mailing Address - Fax:
Practice Address - Street 1:1961 STOUT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80294-1961
Practice Address - Country:US
Practice Address - Phone:303-844-7118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9395658163WA0400X
FLRN9395856163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)