Provider Demographics
NPI:1386311876
Name:BOOMHOWER, CLAIRE KRISTEN (RN)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:KRISTEN
Last Name:BOOMHOWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:KRISTEN
Other - Last Name:DUGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:532 LANDMARK BLF
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-4408
Mailing Address - Country:US
Mailing Address - Phone:361-876-6071
Mailing Address - Fax:
Practice Address - Street 1:12709 TOEPPERWEIN RD STE 306
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3223
Practice Address - Country:US
Practice Address - Phone:210-967-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX879239163W00000X
TX1064901363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily