Basic Information
Provider Information
NPI: 1831647619
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALDERSON
FirstName: PATRICIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 419
Address2:  
City: CULBERTSON
State: MT
PostalCode: 592180419
CountryCode: US
TelephoneNumber: 4067876413
FaxNumber: 4067876453
Practice Location
Address1: 521 4TH ST
Address2:  
City: HAVRE
State: MT
PostalCode: 595013649
CountryCode: US
TelephoneNumber: 4063954305
FaxNumber: 4063954858
Other Information
ProviderEnumerationDate: 09/21/2016
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XNUR-APRN-LIC-104839MTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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