NPI 1457990798 · live from the CMS NPI Registry
Courtney Taylor Boivin, NP
Nurse Practitioner, Pediatrics in Saint Louis, MO. National Provider Identifier 1457990798, active.
NPI record
| NPI | 1457990798 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 12436 Tesson Ferry Rd, Saint Louis, MO 63128 |
| Practice phone | 314-454-6336 |
| Enumerated | January 3, 2020 |
| Last updated | November 2, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 2019043941 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.