Provider Demographics
NPI:1033447248
Name:ASPHOLM, ANNE MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:ASPHOLM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2563
Mailing Address - Country:US
Mailing Address - Phone:406-563-5031
Mailing Address - Fax:
Practice Address - Street 1:814 E PARK AVE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2563
Practice Address - Country:US
Practice Address - Phone:406-563-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-28
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN27537251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care