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General NPI Number Information
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NPI Number | 1578081600
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Entity Type | Individual
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Provider Name | MARY NELSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2017
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1015 BROADWATER AVE STE 101
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City | BILLINGS
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State | MT
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Zip | 59102-5462
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Country | US
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Telephone | 406-657-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 AMHERST DR
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City | BILLINGS
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State | MT
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Zip | 59106-8541
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA-PHA-LIC-63310
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License Number State | MT
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