Individual
MRS. SUZANNE C GULLOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
77 DEER CREEK RD, SOMERS, MT 59932
(406) 857-2997
(406) 857-2996
Mailing address
PO BOX 649, LAKESIDE, MT 59922-0649
(406) 857-2997
(406) 587-2996
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
020838
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0037108
MONTANA BCBS NUMBER
MT
05
—
0434707
—
MT
Enumeration date
07/18/2005
Last updated
07/09/2007
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