Veronica Lou Boone

Individual provider Active NPI Licensed Practical Nurse · Clio, MI

NPI 1407313141 · NPPES record last updated Mar 1, 2019

Key facts

NPI
1407313141
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703076390 (MI)
Practice address
11514 N Belsay Rd
Clio, MI 48420-9756
Phone
(810) 730-3204
NPI assigned
Mar 1, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703076390MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703076390 MI Yes

Addresses

Primary practice location

11514 N Belsay Rd
Clio, MI 48420-9756

Mailing address

11514 N Belsay Rd
Clio, MI 48420-9756

Other providers in Clio, MI

All providers in Clio, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.