KATI BOOMGARDEN FNP NPI 1326577552

NPI Information

NPI: 1326577552
Provider Name: KATI BOOMGARDEN, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2540 SISTER MARY COLUMBA DR
RED BLUFF, CA
ZIP 96080
Phone: (530) 690-2827
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Kati Boomgarden, FNP is a family nurse practitioner in Red Bluff, CA with 7 years of experience. Kati Boomgarden, FNP NPI is 1326577552. 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:

2540 SISTER MARY COLUMBA DR
RED BLUFF, CA
ZIP 96080-327
Phone: (530) 690-2827

The NPI 1326577552 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/10/2017 and was last updated on 3/7/2023.

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	163W00000X	Registered Nurse		845076	CALIFORNIA	No
2	363LF0000X	Nurse Practitioner	Family	95007884	CALIFORNIA	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	Other Provider Identifier Issuer
1	845076	OTHER	CALIFORNIA	BOARD OF REGISTERED NURSING
2	F12170087	OTHER		AANP: CERTIFICATION
3	9500784	OTHER	CALIFORNIA	BOARD OF REGISTERED NURSING

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: 4/28/2024

NPI Synchronization or Removal

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