Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 17898 | MT |
Y | 363LC1500X | Nurse Practitioner - Community Health | NUR-APRN-LIC-100240 | MT |
NPI | 1194748152 |
---|---|
Provider Name | Steven L. Blohm |
First Address | Billings, MT 59107-5100 |
Second Address | Billings, MT 59101-0905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000372550 | BCBS PIN (01) | MT |
0438022 | MDCD PIN (01) | MT |
116616600 | MDCD PIN (01) | WY |
P41788 | (02) | MT |