Healthcare Provider Details

I. General information

NPI: 1831134782
Provider Name (Legal Business Name): GEORGIANNA SUE COON FNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GEORGIANNA SUE MAYER

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WESTWOOD DR
HAMILTON MT
59840-2345
US

IV. Provider business mailing address

1224 W MAIN ST
HAMILTON MT
59840-2338
US

V. Phone/Fax

Practice location:
  • Phone: 406-363-2211
  • Fax:
Mailing address:
  • Phone: 406-363-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNUR-APRN-LIC-100553
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNUR-APRN-LIC-100553
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: