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

Mrs. Mary Teresa Walters, CPNP

Individual provider Nurse Practitioner · NPI 1477042802

Mrs. Mary Teresa Walters, CPNP is a Nurse Practitioner in Boise, Idaho. Qualified in 2017, 9 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
9
Licensed in
ID
In the registry since
2018
What do these letters mean?
CPNP — Certified Pediatric Nurse Practitioner
A nurse practitioner certified in paediatrics.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

100 E Idaho St
Boise, ID 83712
Phone: (208) 381-5111
Fax: (208) 381-5112
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 57929 (ID)

Record details

NPI number1477042802
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP
Sole proprietorNo
NPI enumeratedMay 1, 2018
Last updated in NPPESNovember 5, 2024
Certification dateNovember 5, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Boise