Provider Demographics
NPI:1679983852
Name:NURSING MOMMA
Entity Type:Organization
Organization Name:NURSING MOMMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-465-1690
Mailing Address - Street 1:4538 EMERALD RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-8903
Mailing Address - Country:US
Mailing Address - Phone:406-465-1690
Mailing Address - Fax:
Practice Address - Street 1:4538 EMERALD RIDGE LOOP
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-8903
Practice Address - Country:US
Practice Address - Phone:406-465-1690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT16068332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies