Individual
MONICA LYNN BOARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8790
Mailing address
23 FOREST OAK CT, FENTON, MO 63026-3109
(757) 254-6550
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2013045365
MO
363LF0000X
Family Nurse Practitioner
0024170365
VA
363LF0000X
Family Nurse Practitioner
Primary
2013045365
MO
Other
Enumeration date
09/12/2012
Last updated
01/23/2020
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