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Individual

MRS. CHARLENE PONTORIERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
107 DILWORTH ST, GLENDIVE, MT 59330-2053
(406) 345-8935
(406) 345-8908
Mailing address
107 DILWORTH ST, GLENDIVE, MT 59330-2053
(406) 345-8935
(406) 345-8908

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
23960
MT
363LF0000X
Family Nurse Practitioner
R30872
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000063062
BLUE CROSS OF MT
MT
05
005027
ND
05
0720161
MT
Enumeration date
11/17/2006
Last updated
12/10/2020
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