MARY LAREE KENWORTHY (NPI# 1487267266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487267266 |
| Entity Type | Individual |
| Full Name | MARY LAREE KENWORTHY |
| Practice Address |
500 W Fort St Bldg 88 Boise ID 83702-4598 |
| Practice Telephone | 2084221000 |
| Practice Fax Number | 2084221591 |
| Mailing Telephone | 2084221000 |
| Mailing Fax Number | 2084221591 |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | 8104 | ID | Nursing Service Providers |
| Y | 164W00000X | Licensed Practical Nurse | PN8104 | ID | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205123361 | Mary Ellen Kenworthy | Emergency Medicine | 50 North Perry Street, Pontiac, MI 48342 | 2011-07-08 |
| 1548506645 | Mary Katherine Kenworthy | Counselor | 4500 S Lancaster Rd, Gold Team 116a, Dallas, TX 75216-7167 | 2012-12-17 |
| Street Address |
500 W FORT ST BLDG 88 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-4598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| 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 |
|---|---|---|---|---|
| 1457974669 | Marcey Louise Waugh | Licensed Practical Nurse | 500 W Fort St Bldg 124, Boise, ID 83702-4501 | 2020-05-21 |
| 1992154538 | Carolyn Blasch | Licensed Practical Nurse | 3912 Sage Creek Dr, Boise, ID 83714-5502 | 2016-06-05 |
| 1033723788 | Brian Lynn Lambrecht | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-01 |
| 1811500937 | Rebecca Mccall | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-08-28 |
| 1396358438 | John Wayne Shaffer | Licensed Practical Nurse | 500 W Front St, Boise, ID 83702-7231 | 2020-08-28 |
| 1023621034 | James Hd Hecht | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-08-28 |
| 1316550346 | Deanna Cui Gonzales-murdorf | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-08-28 |
| 1104434950 | Mandie Marie Phillips | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-07-17 |
| 1790302446 | Angela Battle | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-06-29 |
| 1841815149 | Jan Drake | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-06-11 |
| Find all providers in BOISE | ||||
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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.