Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Kongkeo Thiky Walther, ANP

Individual provider Acute Care Nurse Practitioner · NPI 1528433430

Mrs. Kongkeo Thiky Walther, ANP is a Nurse Practitioner in Bridgeton, Missouri. Qualified in 2015, 11 years ago. Practices with Northwest Infectious Disease Services LLC, a 9-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
11
Licensed in
MO
In the registry since
2015
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

12774 Boenker Ln
Bridgeton, MO 63044-2436
Phone: (314) 291-7997
Fax: (314) 739-1471
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4921 Parkview Pl, Saint Louis, MO 63110-1032 — (314) 362-8200

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 2015040094 (MO)

Record details

NPI number1528433430
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP
Sole proprietorNo
NPI enumeratedDecember 3, 2015
Last updated in NPPESDecember 21, 2023
Certification dateOctober 5, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Northwest Infectious Disease Services Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bridgeton