Healthcare Provider Details

I. General information

NPI: 1427201680
Provider Name (Legal Business Name): PIONEER MOUNTAIN NURSING SERVICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N MONTANA AVE STE B6
HELENA MT
59601-3845
US

IV. Provider business mailing address

PO BOX 846
HELENA MT
59624-0846
US

V. Phone/Fax

Practice location:
  • Phone: 406-925-3794
  • Fax: 406-422-5804
Mailing address:
  • Phone: 406-925-3794
  • Fax: 406-422-5804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number8413
License Number StateMT

VIII. Authorized Official

Name: LURA K ROBISON
Title or Position: PROVIDER
Credential: BC APRN
Phone: 406-925-3794