Provider Demographics
NPI:1114135647
Name:AZUREMOUNTAINCHEIF, CATHERINE MAMIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MAMIE
Last Name:AZUREMOUNTAINCHEIF
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-1289
Mailing Address - Country:US
Mailing Address - Phone:406-338-3948
Mailing Address - Fax:406-338-2373
Practice Address - Street 1:503 POPIMI STREET
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417-1289
Practice Address - Country:US
Practice Address - Phone:406-338-3948
Practice Address - Fax:406-338-2373
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23169163WA0400X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)