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General NPI Number Information
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NPI Number | 1043385248
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Entity Type | Organization
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Legal Business Name | MARIANNE M. WILSON
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 802 2ND STREET SE
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City | CUT BANK
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State | MT
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Zip | 59427
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Country | US
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Telephone | 406-873-2236
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Fax | 406-873-2867
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Provider Business Mailing Address
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Address Line | 802 2ND STREET SE
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City | CUT BANK
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State | MT
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Zip | 59427
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Country | US
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Telephone | 406-873-2236
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Fax | 406-873-2867
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Authorized Official
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Title or Position | OWNER DIRECTOR
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Name | MS. MARIANNE M. WILSON
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Credential | RNC
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Telephone | 406-873-2236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | 013820809
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN2262
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License Number State | MT
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