1. Home
  2. Directory
  3. Minnesota
  4. Minnetonka
  5. Nurse Practitioner
  6. NPI Profile

KELLY ANN BOIE PPCNP-BC
NPI 1063485514
Nurse Practitioner - Pediatrics in Minnetonka, MN

Active since February 07, 2006
14001 RIDGEDALE DR, STE 100, MINNETONKA, MN 55305(952) 473-0211(952) 473-7908 Get Directions Write a Review

NPPES record last updated: May 3, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly Ann Boie Ppcnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ANN BOIE PPCNP-BC (NPI 1063485514) is an individual pediatrics provider in Minnetonka, Minnesota, licensed in Minnesota (CNP0812) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1063485514
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameKELLY ANN BOIECredential: PPCNP-BC
Location Address14001 RIDGEDALE DR, STE 100Minnetonka, MN 55305-1781
Mailing Address14001 Ridgedale Dr, Ste 100Minnetonka, MN 55305-1781 · (952) 473-0211 · Fax (952) 473-7908
Phone(952) 473-0211
Fax(952) 473-7908
Sole ProprietorNo
Enumeration DateFebruary 7, 2006
Last NPPES UpdateMay 3, 2016
✔ NPI 1063485514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MN · CNP0812
Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License R1121373 (MN)
14001 RIDGEDALE DR, STE 100, Minnetonka, MN 55305
Open in Google Maps ↗

Other Names 1

Former Name (1)Kelly Ann Overbaugh

Other Identifiers 3

Medicaid731306300MN
Medicare PIN500001375
Medicare UPINP15214

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Boie's NPI number?

The NPI number for Kelly Boie is 1063485514. It was assigned to this individual provider in the NPPES registry on February 7, 2006. The provider is also known as Kelly Ann Overbaugh.

Where is Kelly Boie located?

Kelly Boie practices at 14001 Ridgedale Dr, Ste 100, Minnetonka, MN 55305. The listed phone number is (952) 473-0211.

What is Kelly Boie's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Kelly Boie was last updated on May 3, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.