MRS. MARY TERESA WALTERS (NPI# 1477042802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477042802 |
| Entity Type | Individual |
| Full Name | MRS. MARY TERESA WALTERS |
| Credential | CPNP |
| Practice Address |
100 E Idaho St Boise ID 83712 |
| Mailing Address |
2976 W Mirmonte St Meridian ID 83646-2680 |
| Practice Telephone | 2083815111 |
| Practice Fax Number | 2083815112 |
| Mailing Telephone | 2088673729 |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2018-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 57929 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805645 | Mary Kathryn Walters | Optometrist | 655 Taylor Street, Fort Worth, TX 76102-4821 | 2020-09-09 |
| 1831717016 | Mary Walters | Early Intervention Provider Agency | 5876 Mark Lebleu Rd, Lake Charles, LA 70615-4501 | 2020-07-14 |
| 1649572058 | Mary L. Walters | Developmental Therapist | 211 W Lawrence Ave, Effingham, IL 62401-2630 | 2010-11-17 |
| 1144490210 | Mary Alice Walters | Social Worker | 670 Highway Ninety Two, Boydton, VA 23917-2234 | 2008-03-05 |
| 1942498639 | Mary L Walters | Dietitian, Registered | 268 Kingswood Trl, Toledo, OH 43615-5445 | 2007-10-09 |
| 1659387678 | Mary A Walters | Chiropractor | 1174 Wyoming Ave, Forty Fort, PA 18704-4016 | 2006-07-31 |
| 1588642805 | Mary Ellen Walters | Social Worker | 8950 Villa La Jolla Dr Ste C112, La Jolla, CA 92037-1703 | 2006-01-06 |
| 1104435122 | Mary Walters | Counselor | 76 Vassar St, Worcester, MA 01602-1535 | 2020-07-27 |
| 1376169136 | Mary Colleen Walters | Licensed Practical Nurse | 380 S Portage Path, Akron, OH 44320-2326 | 2020-06-17 |
| 1922504109 | Mary Walters | Registered Nurse | 153 Hazard Ave, Enfield, CT 06082-4592 | 2018-04-05 |
| Street Address |
100 E IDAHO ST |
| City | BOISE |
| State | ID |
| Zip Code | 83712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133776 | Gregory G Janos | Pediatrics | 100 E Idaho St, Suite 200, Boise, ID 83712-6267 | 2005-08-31 |
| 1205444734 | Allison Reed | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-21 |
| 1619585247 | Christina Gullion | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-20 |
| 1548897556 | Brooke Hueftle | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-03-27 |
| 1194364919 | Sarah Rosemarie Hogue | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-26 |
| 1710525167 | Leslie Lynn Lamontagne | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1487292843 | Lauren Zupsic | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1659919199 | Stephanie Matta | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1104464627 | David Blair Wilson | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1386282788 | Jessie Modlin | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588288336 | Katina Ross | Nurse Practitioner | 11695 W Baserri Dr, Boise, ID 83709-1307 | 2020-06-07 |
| 1932741212 | Kylie B Di Lulo | Nurse Practitioner | 1309 E Fall Ct, Boise, ID 83706-5076 | 2019-10-08 |
| 1033638150 | Michael P Lorentzen | Nurse Practitioner | 190 E Bannock St Fl 9, Boise, ID 83712-6241 | 2017-09-11 |
| 1063786648 | Tennessee Phs PC | Nurse Practitioner | 950 W. Bannock Street, Suite 1100, Boise, ID 83702-6140 | 2012-02-29 |
| 1194093344 | Ella Mae Gordon | Nurse Practitioner | 450 West State Street, 4th Floor, Boise, ID 83720-0036 | 2011-12-02 |
| 1174839666 | Meghann R Bostrom | Nurse Practitioner | 13099 W Paint Dr, Boise, ID 83713-1927 | 2010-08-23 |
| 1255653796 | Natalia Khochay | Nurse Practitioner | 1075 N. Curtis Rd., Suite 200, Boise, ID 83706-1300 | 2010-02-25 |
| 1164670378 | Janet Mcreynolds Pelton | Nurse Practitioner | 2074 Roanoke Dr, Boise, ID 83712-7529 | 2008-08-29 |
| 1619155249 | Loreen Anne Nugent | Nurse Practitioner | 3611 Tamarack Dr, Boise, ID 83703-4551 | 2008-02-06 |
| 1891904132 | Mario P Martinez | Nurse Practitioner | 1075 S Curtis Rd, Suite 200, Boise, ID 83706-1350 | 2007-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.