Individual
MELANIE BOERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 OLD HIGHWAY 63 S, SUITE 200, COLUMBIA, MO 65201-6092
(573) 445-4272
(573) 815-2477
Mailing address
5308 TIPTREE CT, COLUMBIA, MO 65203
(573) 474-1054
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
135334
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135334
STATE LICENSE
MO
Enumeration date
05/18/2007
Last updated
03/26/2013
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