| Doctor Name: | MS. DIANE JEANNE BOOMGAARDEN/SAAR |
| NPI Number: | 1073783965 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R114618-3 |
| Business Practice Address: | 1526 30th St Nw Bemidji, MN - 566014133 |
| Business Phone Number: | 2187513280 |
| Business Fax Number: | 2187513298 |
| Mailing Address: | 1526 30th St Nw, BEMIDJI |
| State: | MN |
| Postal Code: | 566014133 |
| Phone Number: | 2187513280 |
| Fax Number: | 2187513298 |
| NPI Enumeration Date: | 03/06/2008 |
| NPI Last Update Date: | 04/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | R114618-3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |