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General NPI Number Information
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NPI Number | 1891458139
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Entity Type | Individual
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Provider Name | KATRINA ANN BOOKER AGACNP-BC, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 1514 JEFFERSON HWY
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City | JEFFERSON
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State | LA
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Zip | 70121-2429
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Country | US
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Telephone | 866-624-7637
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Fax |
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Provider Business Mailing Address
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Address Line | 6417 PALMETTO POINTE DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-8818
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Country | US
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Telephone | 228-990-3905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 904944
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License Number State | MS
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