Healthcare Provider Details

I. General information

NPI: 1558297440
Provider Name (Legal Business Name): TAMI MARIE LARSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 14TH AVE SW
SIDNEY MT
59270-3519
US

IV. Provider business mailing address

216 14TH AVE SW
SIDNEY MT
59270-3519
US

V. Phone/Fax

Practice location:
  • Phone: 406-488-2100
  • Fax: 406-488-2115
Mailing address:
  • Phone: 406-488-2100
  • Fax: 406-488-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberNUR-RN-LIC-127087
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: