MEDICARE: COUNTY OF CHOUTEAU

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	251K00000X	Public Health or Welfare Agency	RN23658	MT

General Provider Information

NPI Number	:	1699967489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF CHOUTEAU

Provider Business Mailing Address
First Line	:	PO BOX 459
Second Line	:	1020 13TH STREET
City	:	FORT BENTON
State	:	MT
Zip	:	59442-0459
Country	:	US
Telephone Number	:	406-622-3771
Fax Number	:	406-622-3411

Provider Business Practice Location Address
First Line	:	1020 13TH STR
Second Line	:
City	:	FORT BENTON
State	:	MT
Zip	:	59442-0459
Country	:	US
Telephone Number	:	406-622-3771
Fax Number	:	406-622-3411

Authorized Official
Title or Position	:	COUNTY HEALTH NURSE
Name	:	ANGEL M JOHNSON
Credential	:	FNP
Telephone Number	:	406-622-3771

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	08/15/2007

Similar Medicare Providers

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Directions to “COUNTY OF CHOUTEAU ” Practice Location

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