Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 174511 | MT |
NPI | 1003401894 |
---|---|
Provider Name | Danice Thorne |
First Address | Trout Creek, MT 59874-1642 |
Second Address | Thompson Falls, MT 59873-9502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2021 |
Last Update Date | 27/07/2021 |