Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 2016029294 | MO |
NPI | 1205381019 |
---|---|
Provider Name | Nia Aragon |
First Address | Columbia, MO 65201-6626 |
Second Address | Columbia, MO 65201-6626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2016 |
Last Update Date | 26/01/2022 |