Most Relevant Information
Provider Data
| NPI Number: | 1003459132 |
| Provider Name: | MARY E BOOTH DNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 2019031435 |
Most Important Dates
| Enumeration Date: | 10/22/2019 |
| Last Updated: | 10/21/2024 |
Provider Practice Location
1 SAINT JOSEPH DR
CENTERVILLE
IA
525449017
Practice Location Phone/Fax
| Phone: | 6418568684 |
| Fax: | 6415485233 |
Provider Mailing Location
1 SAINT JOSEPH DR
CENTERVILLE
IA
525449017
Provider Mailing Phone/Fax
| Phone: | 6414373000 |
| Fax: | 6414373403 |