BEAU G WALKER (NPI# 1558508085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558508085 |
| Entity Type | Individual |
| Full Name | BEAU G WALKER |
| Credential | P.A. |
| Practice Address |
333 N 1st St Suite 280 Boise ID 83702-6100 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2083456545 |
| Practice Fax Number | 2083451213 |
| Mailing Telephone | 2083456545 |
| Mailing Fax Number | 2083451213 |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2012-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-788 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
333 N 1ST ST SUITE 280 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417935966 | Heidi Louise Nagel | Genetic Counselor, MS | 333 N 1st St, Suite 150, Boise, ID 83702-6100 | 2006-01-05 |
| 1558715235 | Laura Mae Defenbach | Genetic Counselor, MS | 333 N 1st St, Suite 150, Boise, ID 83702-6100 | 2016-04-19 |
| 1558799270 | Nita M Barrelier Verner | Nurse Practitioner | 333 N 1st St, Suite #140, Boise, ID 83702-6100 | 2013-10-15 |
| 1780949164 | Cortney Lynn Schnupp | Nurse Practitioner | 333 N 1st St, 240, Boise, ID 83702-6100 | 2012-07-11 |
| 1538476239 | Tyler S Stewart | Physician Assistant | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2010-09-02 |
| 1659699841 | St Luke's Regional Medical Center | Surgery | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2010-05-12 |
| 1366675985 | Sarah R. Sparks | Nurse Practitioner | 333 N 1st St, Suite 140, Boise, ID 83702-6100 | 2009-08-30 |
| 1730311564 | Aaron L Thomason | Nurse Practitioner | 333 N 1st St, Suite 280, Boise, ID 83702-6100 | 2009-08-12 |
| 1295900744 | Jordan D Keyes | Spec/Tech, Cardiovascular | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2008-04-25 |
| 1306026745 | Calvin Thomas Jewell | Surgery | 333 N 1st St, Suite 120, Boise, ID 83702-6100 | 2007-11-13 |
| Find all providers in the same location | ||||
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1891707618 | Brian Keith Lachapelle | Physician Assistant | 6140 W Curtisan, Ste 102, Boise, ID 83704 | 2006-08-12 |
| 1780641530 | Alicia R Borst | Physician Assistant | 3960 W. Wainwright, Boise, ID 83713 | 2006-04-26 |
| 1679090617 | Joel Timothy Mathews | Physician Assistant | 100 E Warm Springs Ave Ste B, Boise, ID 83712-6243 | 2017-08-29 |
| 1073982245 | Kim Wilson | Physician Assistant | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2015-09-17 |
| 1710362710 | Andrew P Swenson | Physician Assistant | 6165 W Emerald, Boise, ID 83704 | 2015-07-21 |
| 1275936981 | Shaylan Pease | Physician Assistant | 6259 W Emerald St, Boise, ID 83704-8731 | 2014-10-08 |
| 1194127472 | Anna Hoskins | Physician Assistant | 1072 N Liberty Street, Ste 201, Boise, ID 83704-8708 | 2014-09-18 |
| 1568891638 | Dominick Valentine | Physician Assistant | 6140 W Curtisian Ave, Suite 102, Boise, ID 83704-8880 | 2013-11-08 |
| 1013342468 | Polina Kokoulina | Physician Assistant | 900 N Liberty St, Ste 101, Boise, ID 83704-8704 | 2013-09-04 |
| 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.