Individual
MS. THERESA LOUISE BOOGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(763) 236-6000
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R162764-4
MN
363LN0000X
Neonatal Nurse Practitioner
RN057338
AZ
Other
Enumeration date
03/29/2006
Last updated
09/29/2009
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