Individual
MARY C DE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP ANP
Contact information
Practice address
343 SUNNYVIEW LN, KALISPELL, MT 59901-3156
(406) 752-1790
(406) 756-3529
Mailing address
343 SUNNYVIEW LN, KALISPELL, MT 59901-3156
(406) 752-1790
(406) 756-3529
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
101363
MT
363LA2200X
Adult Health Nurse Practitioner
RN26302
MT
364SA2200X
Adult Health Clinical Nurse Specialist
26302
MT
Other
Enumeration date
10/05/2006
Last updated
11/27/2023
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