Provider Demographics
NPI:1114679495
Name:LAHATT, TERESA (NAC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:LAHATT
Suffix:
Gender:F
Credentials:NAC
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:BRUNK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3855 QUARTER CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-9668
Mailing Address - Country:US
Mailing Address - Phone:360-510-7565
Mailing Address - Fax:
Practice Address - Street 1:3855 QUARTER CIRCLE DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-9668
Practice Address - Country:US
Practice Address - Phone:360-510-7565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60123444376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide