Individual
MS. KATHLEEN MARIE BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, NP
Contact information
Practice address
2115 SUMMIT AVE, STUDENT HEALTH SERVICES # 5056, ST PAUL, MN 55105
(651) 962-6750
(651) 962-6751
Mailing address
7 RED PINE RD, NORTH OAKS, MN 55127-2030
(651) 490-7863
(651) 490-7863
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1226809
MN
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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