Marina Faith Mitchell, RN

Individual provider Active NPI Registered Nurse · Lame Deer, MT

NPI 1124375712 · NPPES record last updated Aug 14, 2012

Key facts

NPI
1124375712
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN28519 (MT)
Practice address
100 Cheyenne Ave
Lame Deer, MT 59043
Phone
(406) 477-4400
Fax
(406) 477-3038
NPI assigned
Aug 14, 2012
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

LicenseStateTypeSpecialty
RN28519MTMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN28519 MT Yes

Addresses

Primary practice location

100 Cheyenne Ave
Lame Deer, MT 59043

Mailing address

Box 67, 100 Cheyenne Ave
Lame Deer, MT 59043
Phone (406) 477-4400

Other providers in Lame Deer, MT

All providers in Lame Deer, MT · Registered Nurse in Montana

Sources for this page

Verify at the official NPI Registry.