1952326696 NPI number — LARRY D CURTIS CRNA

Table of content: HAILEY BREE KRULL PT, DPT, CBIS (NPI 1245888148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952326696 NPI number — LARRY D CURTIS CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CURTIS
Provider First Name:
LARRY
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
M

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:
1952326696
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RR1 BOX 11406
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARDIN
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-665-1013
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 SOUTH 7650 EAST
Provider Second Line Business Practice Location Address:
CROW NORTHERN CHEYENNE INDIAN HOSPITAL
Provider Business Practice Location Address City Name:
CROW AGENCY
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-638-3500
Provider Business Practice Location Address Fax Number:
406-638-3569
Provider Enumeration Date:
07/13/2006

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: 367500000X , with the licence number:  RN19388 , 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: 8HJR17 . This is a "MEDICARE LODGE GRASS" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 8HZQ13 . This is a "MEDICARE PRYOR" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 8HZL41 . This is a "PRYOR" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 8HR46X . This is a "MEDICARE CROW" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 8HZH28 . This is a "CROW" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 8HZH38 . This is a "LG" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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