Doctor profile · Federal record
Dr. Mary Koolmo, APRN, CNP
Pediatric Nurse Practitioner · Pediatrics Physician · Saint Paul, MN
- NPI 1821182296
- 20 yrs on file
- Licensed in 2 states
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
347 Smith Ave N, MS 70-302
Saint Paul, MN 551022387
(651) 220-6728
fax (651) 220-5231 - Mailing address
-
347 N. Smith Ave., MS 70-302
St. Paul, MN 55102
Credentials & registration
- NPI registered
- October 2006 — 20 yrs on file
- Profile last updated
- September 23, 2014
- Specialty taxonomy
- 363LP0200X — NUCC code
- State licenses (2)
- Minnesota #R119628-5 · New Mexico #R44402
- Medicaid
- NM #000Z8736
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1821182296. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$82
Transactions
2
Manufacturers
2
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Tg Therapeutics, INC. | 1 | $46.99 | |
| Genentech USA, INC. | 1 | $34.80 |
By nature of payment
Frequently asked questions
What is Dr. Mary Koolmo's medical specialty?
Dr. Mary Koolmo practices Pediatric Nurse Practitioner in Saint Paul, MN.
Where does Dr. Mary Koolmo practice?
Dr. Mary Koolmo practices at 347 Smith Ave N, Saint Paul, MN 551022387. Office phone: 6512206728.
What is Dr. Mary Koolmo's NPI?
Dr. Mary Koolmo's National Provider Identifier (NPI) is 1821182296, issued by NPPES.