Healthcare Provider Details

I. General information

NPI: 1952326696
Provider Name (Legal Business Name): LARRY D CURTIS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 SOUTH 7650 EAST CROW NORTHERN CHEYENNE INDIAN HOSPITAL
CROW AGENCY MT
59022
US

IV. Provider business mailing address

RR1 BOX 11406
HARDIN MT
59034
US

V. Phone/Fax

Practice location:
  • Phone: 406-638-3500
  • Fax: 406-638-3569
Mailing address:
  • Phone: 406-665-1013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN19388
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: