NPI 1770028078 · live from the CMS NPI Registry
Melissa Ann Bommarito, CPNP-PC
Nurse Practitioner, Pediatrics in Saint Louis, MO. National Provider Identifier 1770028078, active.
NPI record
| NPI | 1770028078 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1465 S Grand Blvd, Allergy/Immunology, Saint Louis, MO 63104 |
| Practice phone | 314-268-4014 |
| Enumerated | December 23, 2016 |
| Last updated | March 11, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 2016037790 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.