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NPI Code Detail

MEDICARE: MRS. IRENE MARTIN RN

MEDICARE: MRS. IRENE MARTIN 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
1163W00000XRegistered NurseRN6499MT

General Provider Information

NPI Number : 1720108038
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. IRENE MARTIN RN
Provider Business Mailing Address
First Line : PO BOX 182
Second Line :
City : CUT BANK
State : MT
Zip : 59427-0182
Country : US
Telephone Number : 406-336-2460
Fax Number :
Provider Business Practice Location Address
First Line : 1210 E MAIN ST
Second Line :
City : CUT BANK
State : MT
Zip : 59427-3152
Country : US
Telephone Number : 406-873-2924
Fax Number : 406-873-2205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 07/08/2007

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