Provider Demographics
NPI:1609753391
Name:BOYNTON, DEANGELA D
Entity type:Individual
Prefix:
First Name:DEANGELA
Middle Name:D
Last Name:BOYNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7504 PERRY ST UNIT 31092
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-7504
Mailing Address - Country:US
Mailing Address - Phone:513-601-1362
Mailing Address - Fax:
Practice Address - Street 1:7504 PERRY ST UNIT 31092
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-7504
Practice Address - Country:US
Practice Address - Phone:513-601-1362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH188728164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty