# MRS. CHARLENE PONTORIERO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1457424244
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 23960 | MT | Yes |
| 363LF0000X | Family Nurse Practitioner | R30872 | ND | — |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 12/10/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000063062 | BLUE CROSS OF MT | MT |
| 05 | — | 005027 | — | ND |
| 05 | — | 0720161 | — | MT |