Koolmo, Mary B

Koolmo, Mary B is an individual health care provider with primary practice located at 347 Smith Ave N Ms 70-302, Saint Paul MN 55102-2387. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Koolmo, Mary B can be contacted via phone (651) 220-6728.

Contact Information

Primary practice address
347 Smith Ave N Ms 70-302 Saint Paul MN 55102-2387
Phone: (651) 220-6728
Fax: (651) 220-5231
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X R44402 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R119628-5 Minnesota

Profile Details

NPI number 1821182296
LBN Legal business name Koolmo, Mary B
Credentials APRN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Sep 23rd, 2014 - about 11 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 1821182296 NPPES
New Mexico MEDICAID 000Z8736

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