Healthcare Provider Details

I. General information

NPI: 1124434998
Provider Name (Legal Business Name): LONI MARIE WHITFORD EMT ADVANCED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LONI MARIE TAYLOR EMT ADVANCED

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 01/16/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 CLINIC RD E
BOX ELDER MT
59521-8826
US

IV. Provider business mailing address

PO BOX 179
BOX ELDER MT
59521-0179
US

V. Phone/Fax

Practice location:
  • Phone: 406-395-4902
  • Fax: 406-395-5731
Mailing address:
  • Phone: 406-399-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number6600
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number660
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: