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Individual

ROBERTA J SHUPE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
RR 1 BOX 67, HARLEM, MT 59526-9705
(406) 353-3100
(406) 353-3229
Mailing address
215 3RD ST SW, BOX 1076, HARLEM, MT 59526
(406) 353-2590

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN 14698
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN 14698
LICENSE
MT
Enumeration date
05/23/2007
Last updated
07/08/2007
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