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NPI Code Detail

MEDICARE: MARY VERMILLION RN

MEDICARE:   MARY  VERMILLION  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse72629MT
2163WL0100XLactation Consultant (Registered Nurse)72629MT
3163WW0101XAmbulatory Women's Health Care Registered Nurse72629MT
4163W00000XRegistered Nurse72629MT

General Provider Information

NPI Number : 1285053314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY VERMILLION RN
Provider Business Mailing Address
First Line : 215 S 7TH ST
Second Line :
City : HAMILTON
State : MT
Zip : 59840-2667
Country : US
Telephone Number : 406-880-2551
Fax Number :
Provider Business Practice Location Address
First Line : 1404 WESTWOOD DR
Second Line :
City : HAMILTON
State : MT
Zip : 59840-2315
Country : US
Telephone Number : 406-532-8990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2014
Last Update Date : 06/03/2014

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