MRS. MILISSA RENEE GRANDCHAMP (NPI# 1083750731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083750731 |
| Entity Type | Individual |
| Full Name | MRS. MILISSA RENEE GRANDCHAMP |
| Credential | NP |
| Practice Address |
5 4th Ave. E. Polson MT 59860 |
| Mailing Address |
Po Box 880 St Ignatius MT 59865 |
| Practice Telephone | 4067453525 |
| Practice Fax Number | 4067453529 |
| Mailing Telephone | 4067453525 |
| Mailing Fax Number | 4067453529 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2013-12-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 23008 | MT | Nursing Service Providers |
| Y | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
NUR-RN-LIC-23008 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5 4TH AVE. E. |
| City | POLSON |
| State | MT |
| Zip Code | 59860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174967277 | Samantha Alexandria Clark | Dentist | 5 4th Ave. E., Polson, MT 59860 | 2013-04-19 |
| 1750626693 | Joshua Joseph Labau | Pharmacist | 5 4th Ave. E., Polson, MT 59860 | 2012-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679095020 | Ashley J Gilham | Registered Nurse | #5 4th Ave E., Polson, MT 59860 | 2017-07-07 |
| 1225585532 | St. Luke Community Hospital | Clinic/Center | 107 Ridgewater Dr., Polson, MT 59860 | 2016-09-02 |
| 1306202163 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 7 13th Ave East, Polson, MT 59860 | 2016-01-11 |
| 1154730364 | Wanda L King | Dietitian, Registered | 6 Thirteenth Avenue East, Poslon, MT 59860 | 2014-08-13 |
| 1104255637 | Dacia Lee Antiste-fisher | Counselor | #5 4th Ave. E., Polson, MT 59860 | 2013-11-05 |
| 1154758134 | Richard Pierre | Pharmacy Technician | 5 4th Ave E., Polson, MT 59860 | 2013-10-04 |
| 1154755197 | Wal-mart Stores, Inc | Durable Medical Equipment & Medical Supplies | 36318 Memory Lane, Polson, MT 59860 | 2013-08-27 |
| 1245582022 | Catherine D Addison | Registered Nurse | 5 4th Ave. East, Polson, MT 59860 | 2012-10-04 |
| 1114220787 | Erika Ann Weber | Social Worker | #5 4th Ave. E, Polson, MT 59860 | 2010-12-21 |
| 1942431473 | Lisa L. Scalpane | Counselor | 803 Main Street, Suite C, Polson, MT 59860 | 2009-07-31 |
| Find all providers in zip 59860 | ||||
| Taxonomy Code | 364SF0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Family Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821320508 | High Plains Family Healthcare, LLC | Clinical Nurse Specialist | 88 Johannes Ave, Suite A, Big Sandy, MT 59520 | 2010-02-05 |
| 1225213671 | Cynde Anne Watkins | Clinical Nurse Specialist | 2475 E Broadway St, Helena, MT 59601-4928 | 2008-01-04 |
Please comment or provide details below to improve the information on MRS. MILISSA RENEE GRANDCHAMP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.