Individual
MISTY VANNICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
634 EDDY AVE, MISSOULA, MT 59812-1851
(406) 243-4330
(406) 243-6946
Mailing address
634 EDDY AVE, MISSOULA, MT 59812-1851
(406) 243-4330
(406) 243-6949
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
NUR-RN-LIC-70225
MT
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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