Janet Nordrum

Individual provider Active NPI General Practice Registered Nurse · Box Elder, MT

NPI 1114405487 · NPPES record last updated Jul 30, 2018

Key facts

NPI
1114405487
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
12679 (MT)
Practice address
6850 Upper Box Elder Rd
Box Elder, MT 59521-9073
Phone
(406) 395-1656
NPI assigned
Jul 30, 2018
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

LicenseStateTypeSpecialty
12679MTMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse
Group: 193200000X MULTI-SPECIALTY GROUP
163WG0000X 12679 MT Yes

Addresses

Primary practice location

6850 Upper Box Elder Rd
Box Elder, MT 59521-9073

Mailing address

1325 Ike Ave
Havre, MT 59501-5137
Phone (406) 262-4537

Other providers in Box Elder, MT

All providers in Box Elder, MT · General Practice Registered Nurse in Montana

Sources for this page

Verify at the official NPI Registry.