Healthcare Provider Details

I. General information

NPI: 1760697239
Provider Name (Legal Business Name): COUNTY OF PRAIRIE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 SOUTH LOGAN AVE
TERRY MT
59349-0125
US

IV. Provider business mailing address

P.O. BOX 202
TERRY MT
59349-0125
US

V. Phone/Fax

Practice location:
  • Phone: 406-635-2020
  • Fax: 406-635-5575
Mailing address:
  • Phone: 406-635-2020
  • Fax: 406-635-5575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS MEGAN E OLSON
Title or Position: PUBLIC HEALTH RN
Credential: RN
Phone: 406-635-2020