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Contact Information

MARY T WALTERS, CPNP
100 E IDAHO ST
BOISE, ID83712
 Phone: 208-381-5111
 Fax: 208-381-5112
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MARY T WALTERS · (Female)

NPI Number 1477042802
Status Active
Credentials CPNP (Certified Pediatric Nurse Practitioner)
Entity Individual
Enumeration date 05/01/2018
Last updated 11/05/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • ID License # 57929
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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