Provider Demographics
NPI:1912236621
Name:MCWHORTER, MARY JEAN
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JEAN
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 GOLD RUSH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5863
Mailing Address - Country:US
Mailing Address - Phone:406-443-1461
Mailing Address - Fax:406-443-1461
Practice Address - Street 1:2103 GOLD RUSH AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5863
Practice Address - Country:US
Practice Address - Phone:406-443-1461
Practice Address - Fax:406-443-1461
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant