Provider Demographics
NPI:1932262599
Name:ANNAU, RAYMONE JEANINE (FNP APRN)
Entity Type:Individual
Prefix:MS
First Name:RAYMONE
Middle Name:JEANINE
Last Name:ANNAU
Suffix:
Gender:F
Credentials:FNP APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-6522
Mailing Address - Country:US
Mailing Address - Phone:406-453-9272
Mailing Address - Fax:
Practice Address - Street 1:900 6TH ST SW
Practice Address - Street 2:SUITE2
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-3207
Practice Address - Country:US
Practice Address - Phone:406-727-3242
Practice Address - Fax:406-727-3161
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN6732363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTP14679Medicare UPIN