1689829616 NPI number — MRS. CHRISTIA ANDERSON MONROE RPT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689829616 NPI number — MRS. CHRISTIA ANDERSON MONROE RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONROE
Provider First Name:
CHRISTIA
Provider Middle Name:
ANDERSON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PUCKETT
Provider Other First Name:
CHRISTIA
Provider Other Middle Name:
ANDERSON
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689829616
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160010
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIG SKY
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59716-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-995-7525
Provider Business Mailing Address Fax Number:
406-995-7528

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
795 LITTLE COYOTE RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG SKY
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59716-0010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-995-7525
Provider Business Practice Location Address Fax Number:
406-995-7528
Provider Enumeration Date:
11/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  1346 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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