Shayna Wilson
Individual provider Active NPI Legal Medicine · Troy, MT
NPI 1639554207 · NPPES record last updated Jul 24, 2015
Key facts
- NPI
- 1639554207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Legal Medicine 173000000X
- License
- LMT-LMTLIC2633 (MT)
- Practice address
- 304 North 2ND Street
Troy, MT 59935 - Phone
- (406) 295-4044
- NPI assigned
- Jul 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| LMT-LMTLIC2633 | MT | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shayna Wilson Massage | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | LMT-LMTLIC2633 | MT | Yes |
Addresses
Primary practice location
304 North 2ND Street
Troy, MT 59935
Mailing address
PO Box 1068
Troy, MT 59935-1068
Phone (406) 295-4044
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 371665384 | Other | INS. |
Other providers in Troy, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2015. 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.