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General NPI Number Information
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NPI Number | 1013149681
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Entity Type | Individual
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Provider Name | ANN M HOST MES, PRP
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Gender | Female
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 404 JACKSON AVE
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City | MURDO
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State | SD
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Zip | 57559
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Country | US
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Telephone | 605-530-0544
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Fax | 605-669-2102
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Provider Business Mailing Address
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Address Line | PO BOX 152
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City | MURDO
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State | SD
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Zip | 57559-0152
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Country | US
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Telephone | 605-530-0544
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Fax | 605-669-2102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5AP15-98
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License Number State | CA
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