KATELYN ROSE WILLIS NPI 1003613316

NPI Information

  • NPI: 1003613316
  • Provider Name: KATELYN ROSE WILLIS
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 3230 NINA DR
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 243-6077

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NPI Details

Katelyn Rose Willis is a family nurse practitioner in Idaho Falls, ID. Katelyn Rose Willis NPI is 1003613316. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3230 NINA DR
IDAHO FALLS, ID
ZIP 83404-428
Phone: (208) 243-6077

The enumeration date for this NPI number is 2/26/2025 and was last updated on 2/26/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily4071550IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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