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Individual

AIDA TRIVIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
802 MEL CARNAHAN DR, APT 2015, HILLSBORO, MO 63050-2427
(636) 543-2290
(636) 789-2523
Mailing address
1301 BOONES LICK RD, SAINT CHARLES, MO 63301-2463
(636) 916-8228
(636) 946-5774

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2005018080
MO

Other

Enumeration date
11/12/2009
Last updated
03/11/2015
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