1386073716 NPI number — ANNA M DANZ WHNP

Table of content: ANNA M DANZ WHNP (NPI 1386073716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386073716 NPI number — ANNA M DANZ WHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANZ
Provider First Name:
ANNA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
WHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386073716
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1035 1ST AVE W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KALISPELL
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59901-5607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-751-8113
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13526 CRESCENT MOON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIGFORK
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59911-6091
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-779-7623
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/06/2013

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: 363LW0102X , with the licence number:  728514 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: 124787 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: NUR-APRN-LIC-124787 , 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)