MEDICARE: ABBEY TAVARES 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
1	163W00000X	Registered Nurse	234332	MT

General Provider Information

NPI Number	:	1699624866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBEY TAVARES RN

Provider Business Mailing Address
First Line	:	20780 US HIGHWAY 93 N
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-8582
Country	:	US
Telephone Number	:	435-375-9669
Fax Number	:

Provider Business Practice Location Address
First Line	:	20780 US HIGHWAY 93 N
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-8582
Country	:	US
Telephone Number	:	435-375-9669
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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