Individual provider Active NPI

Maree Bullers, NNP

  • Neonatal Nurse Practitioner
  • Boise, ID
National Provider Identifier
1699403360
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
2271863 Issued in ID
Practice address
190 E Bannock St
Boise, ID 83712-6241
Phone
(208) 381-2088
Fax
(208) 381-2893
NPI assigned
Aug 10, 2022
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 1089696 TX
Neonatal Nurse Practitioner 363LN0000X 2271863 ID Primary

Addresses

Primary practice location

190 E Bannock St
Boise, ID 83712-6241

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8752

Other practice location 1

921 Gessner Rd
Houston, TX 77024-2501
Phone (409) 789-2826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221020000308 TX Practitioner - Nurse Practitioner 1850767583 Reassigns benefits to 1 organization
I20251130000161 ID Practitioner - Nurse Practitioner 1850767583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Texas Medical Branch at Galveston, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Boise, ID 83701

PO Box
Suite 640
Boise, ID 83701-0640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2271863IDMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 12, 2022 Accepting new patients
Ut Physicians CurrentSince Sep 12, 2022 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Neonatal-Perinatal Medicine CurrentSince Oct 1, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Oct 1, 2025 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1699403360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2088",
            "fax_number": "208-381-2893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Gessner Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242501",
            "country_code": "US",
            "telephone_number": "409-789-2826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLERS",
        "first_name": "MAREE",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "1089696",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "ID",
            "license": "2271863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.