Theresa Louise Boogaard, NP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

R162764-4 Issued in MN

Practice address

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522

Phone

(763) 236-6000

NPI assigned

Mar 29, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Theresa Louise Hunter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1366403420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MR 10809",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-4813",
            "fax_number": "612-262-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-236-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOGAARD",
        "first_name": "THERESA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AZ",
            "license": "RN057338",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "R162764-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "HUNTER",
            "middle_name": "LOUISE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew Boldt, D.P.T.
• Krystal Bollinger
• Katherine M.C. Bolterman, D.D.S.
• Justin Bonasera
• Carrie Ann Brooks Bonde, BCBA
• Amanda Boothby, DPT
• Calvin Boots, OD
• John Chester Bordwell, MD
• Kristi Sue Borowski, MD
• Angela Suzanne Bothwell

• Neonatal Nurse Practitioner in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Neonatal Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.