Individual provider · NPI-1

Melanie Boerio

Nurse Practitioner, Pediatrics · Columbia, MO

NPI number1265640783
StatusActive
Last updated in NPPESMar 26, 2013

Details

NPI
1265640783
Entity type
Individual (NPI-1)
Name
Melanie Boerio
Sex
Female
Sole proprietor
No
Enumeration date
May 18, 2007
Last updated
Mar 26, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics135334MOYes

Practice location

1316 Old Highway 63 S
Suite 200
Columbia, MO 65201-6092

Phone 573-445-4272 · Fax 573-815-2477

Mailing address

5308 Tiptree Ct
Columbia, MO 65203

Phone 573-474-1054

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