Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 25730 | MT |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 25730 | MT |
NPI | 1336417005 |
---|---|
Provider Name | Amy Marie Ramer |
First Address | Kalispell, MT 59901 |
Second Address | Kalispell, MT 59901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2011 |
Last Update Date | 29/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MR2526385 | DEA (01) | MT |