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General NPI Number Information
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NPI Number | 1710834338
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Entity Type | Organization
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Legal Business Name | MONTANESTHESIA PLLC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 23 CRAZYHEAD RD
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City | LIVINGSTON
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State | MT
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Zip | 59047-9402
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Country | US
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Telephone | 775-560-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 23 CRAZYHEAD RD
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City | LIVINGSTON
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State | MT
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Zip | 59047-9402
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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 | OWNER/MANAGER
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Name | SHANNON KOLUPAEVA
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Credential | CRNA
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Telephone | 775-560-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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