MR. WALTER R FETTERLEY II (NPI# 1891803482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891803482 |
Entity Type | Individual |
Full Name | MR. WALTER R FETTERLEY II |
Credential | CRNA |
Practice Address |
621 Reserve St Boise ID 83712-6354 |
Practice Telephone | 2085597162 |
Mailing Telephone | 2085597162 |
Enumeration Date | 2006-08-25 |
Last Update Date | 2008-11-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 367500000X | Nurse Anesthetist, Certified Registered | RNA-619 | ID | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KS | 200576850A | 05 | |
ID | 807168100 | 05 |
Street Address |
621 RESERVE ST |
City | BOISE |
State | ID |
Zip Code | 83712-6354 |
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 | 367500000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Anesthetist, Certified Registered |
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (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. 548. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134764293 | Steven J Berg Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 360 E Mallard Dr Ste 125, Boise, ID 83706-3941 | 2019-11-13 |
1760584486 | Margaret Minnaert | Nurse Anesthetist, Certified Registered | 1400 W Bannock St, Boise, ID 83702-5233 | 2006-09-02 |
1417065152 | Overton-stiff Professional Anesthesia Service Ltd | Nurse Anesthetist, Certified Registered | 6302 Talcrest, Boise, ID 83713-1207 | 2006-08-25 |
1326155698 | Rocky N Vulgamore | Nurse Anesthetist, Certified Registered | 5583 N Crimson Way, Boise, ID 83703-2840 | 2006-08-24 |
1801802376 | Sherry Elizabeth Swearngin | Nurse Anesthetist, Certified Registered | 1698 E Seaport Ct, Boise, ID 83706-6333 | 2006-08-01 |
1093736290 | Betty Jean Brosh-schoenecker | Nurse Anesthetist, Certified Registered | 10447 W Bucktail Dr, Boise, ID 83714-9522 | 2006-07-22 |
1477583649 | Derek G Dennis | Nurse Anesthetist, Certified Registered | 2537 W State St, Boise, ID 83702-2200 | 2006-07-04 |
1851369805 | Willam Heady | Nurse Anesthetist, Certified Registered | 7154 W State St #369, Boise, ID 83714-7421 | 2006-03-08 |
1710980537 | Christopher J Sours | Nurse Anesthetist, Certified Registered | 501 W Fort St, Boise, ID 83702-4502 | 2005-05-24 |
1689287021 | Brian Jones | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-08-25 |
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.