MEDICARE: DENISE ROSETTA LLOVET FNP CNM MSN

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
1	363LF0000X	Family Nurse Practitioner	10001	MT
2	367A00000X	Advanced Practice Midwife	100001	MT
3	363LF0000X	Family Nurse Practitioner	100001	MT

General Provider Information

NPI Number	:	1679521231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE ROSETTA LLOVET FNP CNM MSN

Provider Business Mailing Address
First Line	:	PO BOX 2547
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59806-2547
Country	:	US
Telephone Number	:	406-218-8840
Fax Number	:	406-797-1088

Provider Business Practice Location Address
First Line	:	600 W ARTEMOS DR
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59803-1504
Country	:	US
Telephone Number	:	406-218-8840
Fax Number	:	406-797-1088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	04/16/2021

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