MS. KATHLEEN MARIE BOOTH RNC, NP
NPI 1114057510
Nurse Practitioner - Family in St Paul, MN

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

Active since March 06, 2007

2115 SUMMIT AVE, STUDENT HEALTH SERVICES # 5056, ST PAUL, MN 55105(651) 962-6750(651) 962-6751 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Ms. Kathleen Marie Booth Rnc, Np NPPES

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

MS. KATHLEEN MARIE BOOTH RNC, NP (NPI 1114057510) is an individual family provider in St Paul, Minnesota, licensed in Minnesota (R1226809) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1114057510

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. KATHLEEN MARIE BOOTHCredential: RNC, NP

Location Address2115 SUMMIT AVE, STUDENT HEALTH SERVICES # 5056St Paul, MN 55105

Mailing Address7 Red Pine RdNorth Oaks, MN 55127-2030 · (651) 490-7863 · Fax (651) 490-7863

Phone(651) 962-6750

Fax(651) 962-6751

Sole ProprietorNo

Enumeration DateMarch 6, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1114057510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MN · R1226809

2115 SUMMIT AVE, St Paul, MN 55105

Open in Google Maps ↗

Other Identifiers 1

Medicare UPINS55808MN

Other Providers at the Same Location

The following 12 providers are registered at the same or a nearby location.

SHANNON MARIE RISTAU

Student in an Organized Health Care Education/Training Program

2115 SUMMIT AVE, LORAS HALL 406
SAINT PAUL, MN 55105

Ramsey County (503) 396-2896

MADONNA KATHRYN MCDERMOTT CNP

Nurse Practitioner (Adult Health)

2115 SUMMIT AVE, MAIL BOX 5056
SAINT PAUL, MN 55105

Ramsey County (651) 962-6750

DR. SARAH K ARMSTRONG MBA PSYD LP

Psychologist (Clinical)

2115 SUMMIT AVE, MAIL 4040
SAINT PAUL, MN 55105

Ramsey County (651) 962-6780

AMY GILBERTSON ATC

Specialist/Technologist (Athletic Trainer)

2115 SUMMIT AVE, STE 5003
SAINT PAUL, MN 55105

Ramsey County (952) 300-0697

ROBERT ZELESNIKAR ATC

Specialist/Technologist (Athletic Trainer)

2115 SUMMIT AVE, ARC 117E
SAINT PAUL, MN 55105

Ramsey County (612) 703-5142

STUDENT HEALTH SERVICE UNIVERSITY OF ST. THOMAS

Clinic/Center (Student Health)

2115 SUMMIT AVE, MAILBOX #5056
SAINT PAUL, MN 55105

Ramsey County (651) 962-6750

THOMAS ANTHONY OLSON LAT, ATC

Specialist/Technologist (Athletic Trainer)