Boomgarden, Kati

Boomgarden, Kati is an individual health care provider with primary practice located at 2540 Sister Mary Columba Dr , Red Bluff CA 96080-4327. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Boomgarden, Kati can be contacted via phone (530) 690-2827.

Contact Information

Primary practice address
2540 Sister Mary Columba Dr Red Bluff CA 96080-4327
Phone: (530) 690-2827
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 845076 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95007884 California

Profile Details

NPI number 1326577552
LBN Legal business name Boomgarden, Kati
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2017
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326577552 NPPES
California Other 845076 BOARD OF REGISTERED NURSING
California Other F12170087 BOARD OF REGISTERED NURSING
California Other 9500784 BOARD OF REGISTERED NURSING

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