Individual
NIKOLE D BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-7509
Mailing address
660 S EUCLID AVE, CAMPUS BOX 8115, SAINT LOUIS, MO 63110-2380
(314) 362-7509
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2020015335
MO
363A00000X
Physician Assistant
PA 60241973
WA
Other
Enumeration date
08/15/2011
Last updated
02/23/2022
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