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Individual
KELLY BOONE
Active
Individual
KELLY BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
681397
CA
363LF0000X
Family Nurse Practitioner
Primary
95001126
CA
Other
Enumeration date
08/13/2014
Last updated
11/22/2016
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