Mallory Q. De Boom, PA
Physician Assistant · Saint Paul, MN
UnclaimedPANPI 1801540646
- Primary taxonomy
- 363A00000X
- Enumerated
- 2022-02-10
- Practice location
- Saint Paul, MN
- Last NPPES update
- 2026-09-02
State licenses
- MN · Physician assistant · NPPES self-reportedListed on NPI record
- TN · Physician assistant · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.