Kim Marie Boultinghouse

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

72108 Issued in HI

Practice address

94-1141 Akeu PL
Waipahu, HI 96797-4039

Phone

(503) 703-8191

NPI assigned

Apr 17, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1356904049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1141 AKEU PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974039",
            "telephone_number": "503-703-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1141 AKEU PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974039",
            "telephone_number": "503-703-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULTINGHOUSE",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "72108",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "HI",
            "license": "72108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Registered Nurse in Waipahu, HI
• Providers in Waipahu, HI by specialty
• School Registered Nurse in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.