Provider Demographics
NPI:1952326696
Name:CURTIS, LARRY D (CRNA)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:D
Last Name:CURTIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR1 BOX 11406
Mailing Address - Street 2:
Mailing Address - City:HARDIN
Mailing Address - State:MT
Mailing Address - Zip Code:59034
Mailing Address - Country:US
Mailing Address - Phone:406-665-1013
Mailing Address - Fax:
Practice Address - Street 1:1010 SOUTH 7650 EAST
Practice Address - Street 2:CROW NORTHERN CHEYENNE INDIAN HOSPITAL
Practice Address - City:CROW AGENCY
Practice Address - State:MT
Practice Address - Zip Code:59022
Practice Address - Country:US
Practice Address - Phone:406-638-3500
Practice Address - Fax:406-638-3569
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN19388367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8HJR17OtherMEDICARE LODGE GRASS
MT8HZQ13OtherMEDICARE PRYOR
MT8HZL41OtherPRYOR
MT8HR46XOtherMEDICARE CROW
MT8HZH28OtherCROW
MT8HZH38OtherLG
MT8HJR17OtherMEDICARE LODGE GRASS
MT8HZL41OtherPRYOR
MTP58906Medicare UPIN
MT8HR46XOtherMEDICARE CROW