Individual
KRISTIN P. BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2609 NEW HARTFORD RD STE 3, OWENSBORO, KY 42303-1316
(812) 476-7111
(812) 476-7117
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1114048
KY
363LF0000X
Family Nurse Practitioner
Primary
3006532
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12125026
CAQH
—
05
—
201006560
—
IN
05
—
7100124900
—
KY
Enumeration date
07/08/2010
Last updated
02/13/2024
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