MR. WALTER R FETTERLEY II


Address: 621 Reserve St, Boise, ID 83712-6354
Phone: 2085597162

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
KS 200576850A 05
ID 807168100 05

Office Location

Street Address 621 RESERVE ST
City BOISE
State ID
Zip Code 83712-6354

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Taxonomy Information

Taxonomy Code 367500000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Anesthetist, Certified Registered

Taxonomy Definition

(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.

Providers in the same taxonomy and city

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
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City BOISE
Zip Code 83712

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Dataset Information

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.

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