Susanne Vining
Individual provider Active NPI Registered Nurse · Lakeside, MT
NPI 1013726413 · NPPES record last updated Jan 1, 2025
Key facts
- NPI
- 1013726413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- NUR-RN-LIC-197960 (MT)
- Practice address
- 171 Troutbeck Rd
Lakeside, MT 59922-9638 - Phone
- (406) 249-6211
- NPI assigned
- Jan 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NUR-RN-LIC-197960 | MT | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | NUR-RN-LIC-197960 | MT | Yes |
Addresses
Primary practice location
171 Troutbeck Rd
Lakeside, MT 59922-9638
Mailing address
PO Box 1128
Lakeside, MT 59922-1128
Phone (406) 249-6211
Other providers in Lakeside, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 1, 2025. 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.