MEDICARE: MRS. DANETTE A MCINTYRE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN15828	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	370511	OTHER	MT	BCBS OF MT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528171980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANETTE A MCINTYRE FNP

Provider Business Mailing Address
First Line	:	301 KNAPP ST
Second Line	:
City	:	WOLF POINT
State	:	MT
Zip	:	59201-1826
Country	:	US
Telephone Number	:	406-653-2150
Fax Number	:	406-653-6591

Provider Business Practice Location Address
First Line	:	301 KNAPP ST
Second Line	:
City	:	WOLF POINT
State	:	MT
Zip	:	59201-1826
Country	:	US
Telephone Number	:	406-653-2150
Fax Number	:	406-653-6591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	02/08/2008

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