Mary B Koolmo, APRN, CNP is a
Nurse Practitioner - Pediatrics physician based in Saint Paul, Minnesota. Mary B Koolmo is licensed to practice in Minnesota (license number R119628-5) and her current practice location is 347 Smith Ave N, Ms 70-302, Saint Paul, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(651) 220-6728.
NPI number for Mary B Koolmo is 1821182296 and her current mailing address is 347 N. Smith Ave., Ms 70-302, St. Paul, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1821182296.
Physician's Profile
| Full Name | Mary B Koolmo |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Pediatrics |
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| Location | 347 Smith Ave N, Saint Paul, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1821182296
- Provider Enumeration Date: 10/03/2006
- Last Update Date: 09/23/2014
Medical Identifiers
Medical identifiers for Mary B Koolmo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821182296 | NPI | - | NPPES |
| 000Z8736 | Medicaid | NM | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | R44402 (New Mexico) | Secondary |
| 363LP0200X | Nurse Practitioner - Pediatrics | R119628-5 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary B Koolmo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mary B Koolmo, APRN, CNP
347 N. Smith Ave., Ms 70-302,
St. Paul, MN 55102
Ph: (651) 220-6728 | Mary B Koolmo, APRN, CNP
347 Smith Ave N, Ms 70-302,
Saint Paul, MN 55102-2387
Ph: (651) 220-6728 |
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