Provider Demographics
NPI:1275552028
Name:MARCEAU, NITA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NITA
Middle Name:MARIE
Last Name:MARCEAU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 8TH AVE W
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-4303
Mailing Address - Country:US
Mailing Address - Phone:406-892-1089
Mailing Address - Fax:406-892-5551
Practice Address - Street 1:400 VETERANS DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912
Practice Address - Country:US
Practice Address - Phone:406-892-1089
Practice Address - Fax:406-892-5551
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist