Provider Demographics
NPI:1174367031
Name:BOYKIN, SHUNDA TRIMAINE
Entity type:Individual
Prefix:MS
First Name:SHUNDA
Middle Name:TRIMAINE
Last Name:BOYKIN
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 1:2901 ISHEE ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-2601
Mailing Address - Country:US
Mailing Address - Phone:251-287-4750
Mailing Address - Fax:
Practice Address - Street 1:2901 ISHEE ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-2601
Practice Address - Country:US
Practice Address - Phone:251-287-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALXXXXX1966376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide