Individual
MELISSA ANNE BORDENAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
1795 RADIO DR, SUITE D, WOODBURY, MN 55125-9414
(651) 696-5550
Mailing address
931 12TH AVE SE, FOREST LAKE, MN 55025-1922
(651) 464-0112
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
BOR104320461
IL
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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