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MR. WALTER R FETTERLEY CRNA NPI 1891803482


NPI Information

NPI: 1891803482
Provider Name: MR. WALTER R FETTERLEY, CRNA
Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Individual
Address:
621 RESERVE ST
BOISE, ID
ZIP 83712
Phone: (208) 559-7162
Get Directions

MR. Walter R Fetterley, CRNA is a nurse anesthetist certified registered in Boise, ID. The provider is (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. MR. Walter R Fetterley, CRNA NPI is 1891803482. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

621 RESERVE ST
BOISE, ID
ZIP 83712-354
Phone: (208) 559-7162

The enumeration date for this NPI number is 8/25/2006 and was last updated on 11/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367500000XNurse Anesthetist, Certified RegisteredRNA-619IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200576850AMEDICAIDKANSAS
2807168100MEDICAIDIDAHO
31604432MEDICARE ID-TYPE UNSPECIFIEDIDAHOMEDICARE PROVIDER NUMBER
4110017013MEDICARE PINKANSAS

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.