Basic Information
| Provider Information | |||||||||
| NPI: | 1336415884 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORIGEAU | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 880 | ||||||||
| Address2: | |||||||||
| City: | ST. IGNATIUS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4067453525 | ||||||||
| FaxNumber: | 4067454233 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 BITTERROOT JIM ROAD | ||||||||
| Address2: | |||||||||
| City: | ARLEE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4067263224 | ||||||||
| FaxNumber: | 4067264023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2012 | ||||||||
| LastUpdateDate: | 03/29/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 31517 | MT | Y | Nursing Service Providers | Registered Nurse |
No ID Information.