Matthew Herta
Individual provider Active NPI Licensed Practical Nurse · Fort Harrison, MT
NPI 1245533892 · NPPES record last updated Dec 20, 2010
Key facts
- NPI
- 1245533892
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 39675 (MT)
- Practice address
- 3687 Veterans Dr
Fort Harrison, MT 59636-9703 - Phone
- (406) 447-7194
- NPI assigned
- Dec 20, 2010
- Sex
- Male
- 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 |
|---|---|---|---|
| L1495260 | MI | MD | Licensed Practical Nurse |
| 39675 | MT | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 39675 | MT | Yes |
| Licensed Practical Nurse | 164W00000X | L1495260 | MI |
Addresses
Primary practice location
3687 Veterans Dr
Fort Harrison, MT 59636-9703
Mailing address
1200 N Washington St
Helena, MT 59601-3238
Phone (406) 442-4706
Other providers in Fort Harrison, MT
- Aaron Grusonik
- Steven John Guerrero
- Maurice Paul Hamill
- Bradley Raymond Heil
- Kimberlee Belle Hendryx
- Hugh Elliott Hetherington
- David J Hill
- Kathleen Hulett
- Brittney P Innocente
- Shalae Herbert Jessop
All providers in Fort Harrison, MT · Licensed Practical Nurse in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2010. 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.