Individual
CIJI LACOLE BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4200 REGENT ST STE 200, COLUMBUS, OH 43219-6229
(877) 581-2210
(614) 968-8840
Mailing address
870 COUNTY ROAD 412, OPP, AL 36467-8011
(334) 504-1894
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-121182
AL
363LF0000X
Family Nurse Practitioner
Primary
1-121182
AL
Other
Enumeration date
06/19/2019
Last updated
04/25/2024
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