Provider Demographics
NPI:1518670157
Name:TRAN, BOI B (DNP)
Entity Type:Individual
Prefix:
First Name:BOI
Middle Name:B
Last Name:TRAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1722 CLARKSON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4976
Mailing Address - Country:US
Mailing Address - Phone:636-206-2665
Mailing Address - Fax:636-206-2664
Practice Address - Street 1:1722 CLARKSON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4976
Practice Address - Country:US
Practice Address - Phone:636-206-2665
Practice Address - Fax:636-206-2664
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS13-136622-082363LF0000X
MO2023002546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily