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General NPI Number Information
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NPI Number | 1467522615
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Entity Type | Individual
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Provider Name | LOTTIE LUCILLE BLOCK FNP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1075 NORTH MERIDIAN
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City | KALISPELL
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State | MT
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Zip | 59904-3699
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Country | US
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Telephone | 406-752-5673
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Fax | 406-752-5672
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Provider Business Mailing Address
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Address Line | 1075 N MERIDIAN RD 388 YODELIN RIDGE ROAD
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City | KALISPELL
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State | MT
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Zip | 59901-3567
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Country | US
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Telephone | 406-752-5673
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Fax | 406-752-5672
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN33154
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License Number State | MT
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