Provider Demographics
NPI:1871665836
Name:PERSONS, JUNE ELLEN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:ELLEN
Last Name:PERSONS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 71 BOX 1160
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MT
Mailing Address - Zip Code:59003-9702
Mailing Address - Country:US
Mailing Address - Phone:406-477-4400
Mailing Address - Fax:
Practice Address - Street 1:100 CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAME DEER
Practice Address - State:MT
Practice Address - Zip Code:59043
Practice Address - Country:US
Practice Address - Phone:406-477-4400
Practice Address - Fax:406-477-8923
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN23501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily