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Individual

MELISSA BOREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
133 S 500 E, VERNAL, UT 84078-2728
(435) 247-1177
Mailing address
133 S 500 E, VERNAL, UT 84078-2728
(435) 247-1177

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
9012295-3101
UT

Other

Enumeration date
03/26/2015
Last updated
03/26/2015
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