Individual
MRS. BRENDA MARIE DEGRAZIO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2825 FORT MISSOULA RD, STE 217, MISSOULA, MT 59804-7403
(406) 728-8170
(406) 728-9409
Mailing address
PO BOX 12, STE 217, LIBERTY LAKE, WA 99019-0012
(406) 728-8170
(406) 728-9409
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RH019408
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000036190
BCBS
MT
05
—
0433771
—
MT
01
—
81036208059804A005
TRICARE
—
Enumeration date
04/07/2006
Last updated
02/23/2016
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