Kathleen Marie Booth RNC, NP

NPI 1114057510 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1114057510
Gender Female
Enumeration Date 03/06/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2115 SUMMIT AVE
STUDENT HEALTH SERVICES # 5056
ST PAUL MN, 55105, US
Phone (651) 962-6750
Fax (651) 962-6751
Business Location
7 RED PINE RD
NORTH OAKS MN, 55127-2030, US
Phone (651) 490-7863
Fax (651) 490-7863
Toxanomy
Taxonomy Code 363LF0000X
License State Minnesota
License Number R1226809
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According to our database, Ms. Kathleen Marie Booth RNC, NP NPI is 1114057510, taxonomy code is 363LF0000X and license number is R1226809, license state is located at Minnesota. Kathleen Marie Booth RNC, NP physically located at 2115 Summit Ave, St Paul MN, 55105. NPI Number Kathleen Marie Booth RNC, NP has the Individual type.

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1114057510 NPI number is provided on an as is basis without warranty of any kind. 1114057510 is maintained by the National Plan & Provider Enumeration System. The contents of Kathleen Marie Booth RNC, NP are for informational purposes only.