1790877793 NPI number — MEGAN GITTINGS APRN

Table of content: MEGAN GITTINGS APRN (NPI 1790877793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790877793 NPI number — MEGAN GITTINGS APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GITTINGS
Provider First Name:
MEGAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1790877793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
920 FRONT STREET
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
HELENA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59601-3442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-820-3376
Provider Business Mailing Address Fax Number:
406-312-1611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
920 FRONT STREET
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
HELENA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59601-3442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-820-3376
Provider Business Practice Location Address Fax Number:
406-312-1611
Provider Enumeration Date:
09/28/2006

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: 363L00000X , with the licence number:  NUR-APRN-LIC-100340 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 100340 , 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)

  • Identifier: 4307173 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000370131 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: P00259784 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: I-7320352 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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