Provider Demographics
NPI:1427033018
Name:DITCHEY-HELLEMS, SUSAN JEAN (CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JEAN
Last Name:DITCHEY-HELLEMS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4949
Mailing Address - Country:US
Mailing Address - Phone:406-442-1914
Mailing Address - Fax:406-443-2901
Practice Address - Street 1:45 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4949
Practice Address - Country:US
Practice Address - Phone:406-442-1914
Practice Address - Fax:406-443-2901
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN015876367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0432523Medicaid
MT000080004Medicare UPIN
MTR84379Medicare UPIN