1932262599 NPI number — MS. RAYMONE JEANINE ANNAU FNP APRN

Table of content: MS. RAYMONE JEANINE ANNAU FNP APRN (NPI 1932262599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932262599 NPI number — MS. RAYMONE JEANINE ANNAU FNP APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANNAU
Provider First Name:
RAYMONE
Provider Middle Name:
JEANINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP 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:
1932262599
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1812 MOUNTAIN VIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREAT FALLS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59405-6522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-453-9272
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 6TH ST SW
Provider Second Line Business Practice Location Address:
SUITE2
Provider Business Practice Location Address City Name:
GREAT FALLS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59404-3207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-727-3242
Provider Business Practice Location Address Fax Number:
406-727-3161
Provider Enumeration Date:
12/18/2006

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: 363LF0000X , with the licence number:  RN6732 , 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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