Individual
COURTNEY TAYLOR BOIVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12436 TESSON FERRY RD, SAINT LOUIS, MO 63128-2702
(314) 454-6336
Mailing address
12436 TESSON FERRY RD, SAINT LOUIS, MO 63128-2702
(314) 973-5177
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2019043941
MO
Other
Enumeration date
01/03/2020
Last updated
11/02/2021
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