Mary C Boltz, RN
Individual provider Active NPI Registered Nurse · Casper, WY
NPI 1780917682 · NPPES record last updated Sep 9, 2009
Key facts
- NPI
- 1780917682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 7225 (WY)
- Practice address
- 1522 E a St
Casper, WY 82601-2217 - Phone
- (307) 233-6000
- Fax
- (307) 265-0841
- NPI assigned
- Sep 9, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7225 | WY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 7225 | WY | Yes |
Addresses
Primary practice location
1522 E a St
Casper, WY 82601-2217
Mailing address
1522 E a St
Casper, WY 82601-2217
Phone (307) 233-6000
Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.