Bomar, Marilee Green

Bomar, Marilee Green is an individual health care provider with primary practice located at 551 E Southampton Dr , Columbia MO 65201-4236. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Bomar, Marilee Green can be contacted via phone (573) 884-7733.

Contact Information

Primary practice address
551 E Southampton Dr Columbia MO 65201-4236
Phone: (573) 884-7733
Fax: (573) 882-6228
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 128845 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 364SG0600X 128845 Missouri

Profile Details

NPI number 1013954601
LBN Legal business name Bomar, Marilee Green
Credentials Master of Science in Nursing (MSN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated May 3rd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013954601 NPPES
Missouri MEDICAID 420750200

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