Angela Blair Boykin, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

278790 Issued in NY

Practice address

115 Brittin Ave
Bridgeport, CT 06605-3419

Phone

(203) 870-1751

Fax

(203) 870-1751

NPI assigned

May 3, 2011

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 3, 2011.

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1003108572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BRITTIN AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066053419",
            "telephone_number": "203-870-1751",
            "fax_number": "203-870-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRITTIN AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066053419",
            "telephone_number": "203-870-1751",
            "fax_number": "203-870-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR BOYKIN",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CT",
            "license": "11.035623",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "278790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Natica Blake

• All providers in Bridgeport, CT
• Licensed Practical Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.