Individual
KATHERINE BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4335 N STAR WAY STE A, MODESTO, CA 95356-8628
(209) 342-5125
Mailing address
2820 HARVEST RD, MODESTO, CA 95355-3433
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95002833
CA
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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