KELLY ANN BOIE PPCNP-BC NPI 1063485514

NPI Information

NPI: 1063485514
Provider Name: KELLY ANN BOIE, PPCNP-BC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
14001 RIDGEDALE DR, STE 100
MINNETONKA, MN
ZIP 55305
Phone: (952) 473-0211
Get Directions

Kelly Ann Boie, PPCNP-BC is a pediatrics nurse practitioner in Minnetonka, MN. Kelly Ann Boie, PPCNP-BC NPI is 1063485514. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14001 RIDGEDALE DR, STE 100
MINNETONKA, MN
ZIP 55305-781
Phone: (952) 473-0211
Fax: (952) 473-7908

The enumeration date for this NPI number is 2/7/2006 and was last updated on 5/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0200X	Registered Nurse	Pediatrics	R1121373	MINNESOTA	No
2	363LP0200X	Nurse Practitioner	Pediatrics	CNP0812	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	731306300	MEDICAID	MINNESOTA
2	500001375	MEDICARE PIN
3	P15214	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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