Healthcare Provider Details

I. General information

NPI: 1295854628
Provider Name (Legal Business Name): JUANITA A. KITTSON RN,CHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL HILL BLACKFEET COMMUNITY HEALTH HOSPITAL
BROWNING MT
59417
US

IV. Provider business mailing address

BOX 760 BLACKFEET COMMUNITY HEALTH HOSPITAL
BROWNING MT
59417
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-6240
  • Fax: 406-338-6384
Mailing address:
  • Phone: 406-338-6240
  • Fax: 406-338-6384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN25055
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: