Individual
KELLY M BOUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 341-2000
(605) 341-0278
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 418-8000
(701) 857-5031
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R36162
ND
Other
Enumeration date
03/25/2011
Last updated
12/28/2023
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