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Individual

MRS. MARIA WINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
1114 W MAIN, SOUTH VALLEY PEDIATRICS, HAMILTON, MT 59840
(406) 363-5013
(406) 363-3714
Mailing address
1114 W MAIN, SOUTH VALLEY PEDIATRICS, HAMILTON, MT 59840
(406) 363-5013
(406) 363-3714

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN25738
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
373490
BCBS
05
4306168
MT
01
RN 25738
NOT SPECIFIED
MT
Enumeration date
08/11/2005
Last updated
09/26/2007
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