Healthcare Provider Details

I. General information

NPI: 1477801801
Provider Name (Legal Business Name): TERESA L CALLAHAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 N 30TH
BILLINGS MT
59101
US

IV. Provider business mailing address

602 E EMORY RD
LAVINA MT
59046-7014
US

V. Phone/Fax

Practice location:
  • Phone: 406-238-6791
  • Fax:
Mailing address:
  • Phone: 406-839-6234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WF0300X
TaxonomyFlight Registered Nurse
License NumberRN40332
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: