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General NPI Number Information
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NPI Number | 1679901037
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Entity Type | Individual
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Provider Name | MATTHEW MOESER R.N.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 3687 VETERANS DR
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City | FORT HARRISON
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State | MT
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Zip | 59636-9703
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Country | US
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Telephone | 406-442-6410
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Fax |
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Provider Business Mailing Address
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Address Line | 171 COLTER LOOP DR
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City | HELENA
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State | MT
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Zip | 59602-7760
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Country | US
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Telephone | 509-844-4850
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | NUR-RN-LIC-70791
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License Number State | MT
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