Nicole Walls, FNP-BC | |
301 Cedar St, Orofino, ID 83544-9029 | |
(208) 476-5777 | |
Not Available |
Full Name | Nicole Walls |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 301 Cedar St, Orofino, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366151870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 72250 (Idaho) | Secondary |
363LF0000X | Nurse Practitioner - Family | 72250 (Idaho) | Primary |
Entity Name | Clearwater Valley Hospital & Clinics |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073551396 PECOS PAC ID: 0547173346 Enrollment ID: O20031117000264 |
Entity Name | St. Mary's Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841292307 PECOS PAC ID: 5092773168 Enrollment ID: O20050316000814 |
Mailing Address | Practice Location Address |
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Nicole Walls, FNP-BC 301 Cedar St, Orofino, ID 83544-9029 Ph: (208) 476-5777 | Nicole Walls, FNP-BC 301 Cedar St, Orofino, ID 83544-9029 Ph: (208) 476-5777 |
Curtis Jonathan Hartman, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 359 Spur Rd, Orofino, ID 83544 Phone: 208-476-5832 | |
Jami Tyler, DR. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Hospital Dr, Orofino, ID 83544 Phone: 208-476-4511 Fax: 208-476-7898 | |
Ms. Tammy Jo Cochrane, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 301 Cedar St, Orofino, ID 83544 Phone: 208-476-4555 Fax: 208-476-5385 |