Provider Demographics
NPI:1477522076
Name:ROSS, LORINDA M (NP)
Entity Type:Individual
Prefix:
First Name:LORINDA
Middle Name:M
Last Name:ROSS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LORINDA
Other - Middle Name:
Other - Last Name:DOEDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:300 N WILLSON
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715
Mailing Address - Country:US
Mailing Address - Phone:406-587-0681
Mailing Address - Fax:406-587-9011
Practice Address - Street 1:300 N WILLSON
Practice Address - Street 2:SUITE 2001
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-587-0681
Practice Address - Fax:406-587-9011
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-13511363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0434616Medicaid
MT000037133OtherBCBS
MT000082939Medicare ID - Type UnspecifiedMEDICARE
MT0434616Medicaid