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General NPI Number Information
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NPI Number | 1063115434
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Entity Type | Individual
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Provider Name | SUSAN DARCY ALTONA REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 425 SMELTER AVE NE
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City | GREAT FALLS
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State | MT
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Zip | 59404-1927
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Country | US
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Telephone | 406-247-7130
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Fax | 406-247-7232
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Provider Business Mailing Address
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Address Line | 1606 9TH ST NW
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City | GREAT FALLS
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State | MT
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Zip | 59404-1824
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Country | US
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Telephone | 406-750-2192
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Fax |
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 46690
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License Number State | MT
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