| NPI | 1518493683 |
|---|---|
| Professional Name | MELODY SUE BOURBEAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 026761) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OH 020761) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2018-09-25 |