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General NPI Number Information
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NPI Number | 1679961841
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Entity Type | Individual
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Provider Name | DONNA EARLEY
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Gender | Female
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 99 MAPLE WAY
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City | KALISPELL
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State | MT
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Zip | 59901
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Country | US
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Telephone | 406-253-9645
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 538
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City | SOMERS
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State | MT
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Zip | 59932
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Country | US
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Telephone | 406-253-9645
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 347740
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License Number State | MT
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