Peterson, Pamela B
Peterson, Pamela B is an individual health care provider with primary practice located at 2360 Mullan Rd Ste C , Missoula MT 59808-1811. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Peterson, Pamela B can be contacted via phone (406) 721-4436.Contact Information
Primary practice address
2360 Mullan Rd Ste C
Missoula MT 59808-1811
Phone: (406) 721-4436
Fax: (406) 542-1037
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN18519 | Montana |
Profile Details
| NPI number | 1073656682 |
|---|---|
| LBN Legal business name | Peterson, Pamela B |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2007 |
| Last updated | Aug 26th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073656682 | NPPES |
| Montana | MEDICAID | 0439998 | |
| Montana | Other | 500027942 CK5082 | |
| Montana | Other | 000372730 | |
| Montana | MEDICAID | 806516800 |
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