Female

Kelly A. Boie PPCNP-BC

Pediatric Nurse Practitioner in Minnetonka, MN(View on Map)

Full Name

Kelly Ann Boie PPCNP-BC

NPI Number

1063485514

NPI Type

Individual Provider

Gender

Female

Enumeration Date

02/07/2006

Specialties

(Taxonomies)

Code

363LP0200X
163WP0200X

Primary Taxonomy

Yes
No

Licenses

State

Minnesota
Minnesota

License Number

CNP0812
R1121373

Contact
Information

Purpose

Mailing
Location

Address

14001 RIDGEDALE DR, STE 100
14001 RIDGEDALE DR, STE 100

City

Minnetonka
Minnetonka

State

MN
MN

Postal Code

55305-1781
55305-1781

Country

US
US

Telephone Number

(952) 473-0211
(952) 473-0211

Identifiers

Identifier

731306300

Identifier State

MN

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/03/2016

Provider Address

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