Provider Demographics
NPI:1760697239
Name:COUNTY OF PRAIRIE
Entity Type:Organization
Organization Name:COUNTY OF PRAIRIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH RN
Authorized Official - Prefix:MISS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-635-2020
Mailing Address - Street 1:P.O. BOX 202
Mailing Address - Street 2:
Mailing Address - City:TERRY
Mailing Address - State:MT
Mailing Address - Zip Code:59349-0125
Mailing Address - Country:US
Mailing Address - Phone:406-635-2020
Mailing Address - Fax:406-635-5575
Practice Address - Street 1:203 SOUTH LOGAN AVE
Practice Address - Street 2:
Practice Address - City:TERRY
Practice Address - State:MT
Practice Address - Zip Code:59349-0125
Practice Address - Country:US
Practice Address - Phone:406-635-2020
Practice Address - Fax:406-635-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT011004022Medicare PIN