SUZANNE C GULLOTTA NPI 1699872010

NPI Information

NPI: 1699872010
Provider Name: SUZANNE C GULLOTTA

Doing Business As: LAKESIDE FAMILY HEALTH CENTER

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
77 DEER CREEK ROAD
SOMERS, MT
ZIP 59932
Phone: (406) 857-2997
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SUZANNE C GULLOTTA is a family nurse practitioner in Somers, MT. SUZANNE C GULLOTTA NPI is 1699872010. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lakeside Family Health Center.

The provider's business location address is:

77 DEER CREEK ROAD
SOMERS, MT
ZIP 59932
Phone: (406) 857-2997

The provider's authorized official is Suzanne C Gullotta .
The authorized official title is Owner and has the following contact phone number (406) 857-2997.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 1/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	020838	MONTANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S36092	MEDICARE UPIN	MONTANA
2	037108	OTHER	MONTANA	BCBS
3	0434707	MEDICAID	MONTANA
4	000084234	MEDICARE PIN	MONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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