Provider Demographics
NPI:1225827793
Name:NIBOH, LAURA BO-KHIA (WHNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BO-KHIA
Last Name:NIBOH
Suffix:
Gender:
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 HIGHLANDS PLAZA DRIVE
Mailing Address - Street 2:#280
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1351
Mailing Address - Country:US
Mailing Address - Phone:314-286-2620
Mailing Address - Fax:
Practice Address - Street 1:1110 HIGHLANDS PLAZA DRIVE
Practice Address - Street 2:#280
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1351
Practice Address - Country:US
Practice Address - Phone:314-286-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016017714363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health