CONNIE JO WALTERS (NPI# 1881134112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881134112 |
| Entity Type | Individual |
| Full Name | CONNIE JO WALTERS |
| Credential | LPN |
| Practice Address |
24276 166th Street Airport Rd Eagle Butte SD 57625-1012 |
| Mailing Address |
Po Box 1012 Eagle Butte SD 57625-1012 |
| Practice Telephone | 6059647724 |
| Mailing Telephone | 6059647724 |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | P012241 | SD | Nursing Service Providers |
| Street Address |
24276 166TH STREET AIRPORT RD |
| City | EAGLE BUTTE |
| State | SD |
| Zip Code | 57625-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170173 | Laura Sue Hunt | Registered Nurse | 24276 166th Street Airport Rd, Eagle Butte, SD 57625-0590 | 2020-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998359 | Jill M Marshall | Registered Nurse | 24279 166th St. Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
| 1871110890 | Stephen Andrew Williams | Registered Nurse | 24767 166th St, Eagle Butte, SD 57625 | 2020-06-26 |
| 1730706706 | Shannon Renee Brautigan | Registered Nurse | 24276 166th Street Airport Rd., Eagle Butte, SD 57625 | 2020-06-25 |
| 1598327827 | Lucy Manu | Pharmacist | 24276 166th Street; Airport Road, Eagle Butte, SD 57625 | 2019-07-08 |
| 1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
| 1063976025 | Jeff Dixon | Pharmacist | Cheyenne River Health Center 24276 Airport Rd., 166th S, Eagle Butte, SD 57625 | 2019-01-24 |
| 1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
| 1447765987 | Deidra Monique Hall | Nurse's Aide | 211 S Spiel Court, Eagle Butte, SD 57625 | 2017-12-06 |
| 1295271070 | Cree Iron Cloud | Registered Nurse | #24276 Airport Rd, Eagle Butte, SD 57625 | 2017-01-17 |
| 1326413618 | Linda Bruguier | Registered Nurse | 24276 166 St Airport Rd, Box 1012, Eagle Butte, SD 57625 | 2015-12-11 |
| Find all providers in zip 57625 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699175380 | Ann'd Butcher | Licensed Practical Nurse | 166 St. Airport Rd, 24276, Eagle Butte, SD 57625-1012 | 2014-08-29 |
| 1891037065 | Theresa A Yazzie | Licensed Practical Nurse | 24276 166th St. Airport Rd, Eagle Butte, SD 57625 | 2013-03-26 |
| 1316200934 | Kate Eaglestaff | Licensed Practical Nurse | 24276 166th St. Airport Raod, Eagle Butte, SD 57625 | 2012-06-19 |
| 1487271409 | Wendy Cara Cook | Licensed Practical Nurse | 24276 166th St Airport Road, Eagle Butte, SD 57625 | 2020-06-26 |
| 1609116524 | Mary Jo Dupris | Licensed Practical Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2013-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588217400 | Lorella L Pritt | Licensed Practical Nurse | 708 Southside St, Valley Springs, SD 57068-9354 | 2019-07-19 |
| 1245720077 | Sara Elizabeth Schaller | Licensed Practical Nurse | 1316 Copperdale Dr, Rapid City, SD 57703-4717 | 2018-05-17 |
| 1023510153 | Shevada Tools | Licensed Practical Nurse | 5400 W Berkshire Blvd Apt 203, Sioux Falls, SD 57106-3611 | 2018-03-05 |
| 1851813224 | Angie Deneire | Licensed Practical Nurse | 7312 Pinon Jay Circle, Rapid City, SD 57702 | 2017-07-07 |
| 1134678915 | Laura Steichen | Licensed Practical Nurse | 609 Saint Gregory St, Harrisburg, SD 57032-2252 | 2016-09-22 |
| 1356895163 | Vladislav Bykov | Licensed Practical Nurse | 3408 E Madison St, Sioux Falls, SD 57103-6202 | 2016-08-09 |
| 1740646892 | Danielle Lynne Fitz | Licensed Practical Nurse | 507 Old Agency Dr, Unit 137a, Sisseton, SD 57262-7226 | 2016-01-05 |
| 1508245358 | Jesika Garrett | Licensed Practical Nurse | 109 Airport Place, Buffalo, SD 57720-0103 | 2015-05-27 |
| 1851790695 | Laura Elgersma | Licensed Practical Nurse | 100 S Shebal Ave Apt 5, Harrisburg, SD 57032-2244 | 2014-08-18 |
| 1285045674 | Amber Rae Peterson | Licensed Practical Nurse | 7404 Timberline Ct, Black Hawk, SD 57718-9545 | 2014-05-19 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE BUTTE |
| Zip Code | 57625 |
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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.