GEORGIA G MAYNARD (NPI# 1255361499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255361499 |
| Entity Type | Individual |
| Full Name | GEORGIA G MAYNARD |
| Credential | CPNP |
| Practice Address |
2835 Fort Missoula Road Missoula MT 59804-7408 |
| Mailing Address |
Po Box 7609 Missoula MT 59807-7609 |
| Practice Telephone | 4067215600 |
| Practice Fax Number | 4067213907 |
| Mailing Telephone | 4067215600 |
| Mailing Fax Number | 4067213907 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN8352 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0432159 | 05 |
| Street Address |
2835 FORT MISSOULA ROAD |
| City | MISSOULA |
| State | MT |
| Zip Code | 59804-7408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841247467 | Dirk R Gottman | Pediatrics | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-05-28 |
| 1144230368 | Anne Manktelow | Surgery | 2835 Fort Missoula Road, Ste 306 Pediatric Surgery of Montana, Missoula, MT 59804 | 2006-08-09 |
| 1528002821 | Kristene A Provo | Physician Assistant | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-16 |
| 1346281359 | Lindsay A Richards | Obstetrics & Gynecology | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-09 |
| 1457391203 | Eric J Kress | Family Medicine | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-08 |
| 1235179508 | Kathleen S Rogers | Pediatrics | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063019297 | Momentum Speech Therapy, PC | Speech-Language Pathologist | 9885 O'brien Creek Road, Missoula, MT 59804 | 2020-10-01 |
| 1033633037 | Marissa Clark | Genetic Counselor, MS | 2827 Fort Missoula Rd., Suite 317, Missoula, MT 59804 | 2017-08-01 |
| 1104295245 | Scott Richter | Specialist/Technologist | 2892 Ringo Dr, Missoula, MT 59804 | 2015-09-18 |
| 1467860353 | Zachary Ueland | Pharmacist | 4000 Highway 93 South, Missoula, MT 59804 | 2014-07-24 |
| 1316378185 | Tracy Laurel Brothers | Counselor | 1305 Wyoming Street, Missoula, MT 59804 | 2013-12-04 |
| 1447683651 | Granite Pharmacy Missoula, LLC | Durable Medical Equipment & Medical Supplies | 2230 27th Ave. West, Suite 2, Missoula, MT 59804 | 2013-08-12 |
| 1871843953 | Autum Emerson Howell | Nurse Practitioner | 2831 Ft. Missoula Rd. Bldg 2, 102, Missoula, MT 59804 | 2012-09-14 |
| 1821353939 | Carlyn Doyle | Nurse Practitioner | 2835 Fort Missoula Rd Ste 203, Missoula, MT 59804 | 2012-07-05 |
| 1396011961 | Patricia Jean Evans | Internal Medicine | 702 S.w. Higgins, First Choice Medical Clinic, Missoula, MT 59804 | 2012-03-28 |
| 1205126794 | Pacific Medical, Inc. | Prosthetic/Orthotic Supplier | 2732 South Ave West, Suite 202, Missoula, MT 59804 | 2011-04-18 |
| Find all providers in zip 59804 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417424425 | Claire Alexandra Steinberg | Nurse Practitioner | 2835 Fort Missoula Rd Ste 301, Missoula, MT 59804-7424 | 2018-10-29 |
| 1821353939 | Carlyn Doyle | Nurse Practitioner | 2835 Fort Missoula Rd Ste 203, Missoula, MT 59804 | 2012-07-05 |
| 1669622841 | Tara L Patrick | Nurse Practitioner | 2835 Fort Missoula Rd, Missoula, MT 59804-7423 | 2008-09-24 |
| 1871776963 | Wendy A Haller | Nurse Practitioner | 2835 Fort Missoula Rd, Missoula, MT 59804-7423 | 2007-12-11 |
| 1396859690 | Linda G Lau | Nurse Practitioner | 2835 Fort Missoula Rd, Building 3, Suite 301, Missoula, MT 59804-7423 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871009548 | Chandice Yvonne Covington | Nurse Practitioner | 415 13th Ave East, Poplar, MT 59255 | 2017-12-18 |
| 1770917544 | Julie Heather Alexander-ruff | Nurse Practitioner | 1417 13th Avenue East, Poplar, MT 59255-0000 | 2013-08-28 |
| 1578841912 | Sara G Goroski | Nurse Practitioner | 1300 28th St S Ste 6, Benefis Hospital Pediatrics, Great Falls, MT 59405-5296 | 2011-08-03 |
| 1437299831 | Mary Pat Hansen | Nurse Practitioner | 1114 W Main St, South Valley Pediatrics, Hamilton, MT 59840 | 2007-02-07 |
| 1467512673 | Paul Albert Sattler | Nurse Practitioner | Blackfeet Community Hospital, 760 Hosital Way, Browning, MT 59417 | 2006-12-11 |
| 1306954136 | Paula J Coleman | Nurse Practitioner | 1001 River Dr, Livingston, MT 59047-3716 | 2006-08-29 |
| 1598737017 | Arlys Williams | Nurse Practitioner | 20 13th St, Havre, MT 59501-5222 | 2006-02-07 |
| 1225024086 | Lynne Arlene Foss | Nurse Practitioner | 206 Alaska Frontage Rd, Belgrade, MT 59714-7909 | 2005-09-27 |
| 1417954579 | Lisa A Schuler | Nurse Practitioner | 926 13th Ave S, Great Falls, MT 59405-4406 | 2005-07-05 |
| 1659374130 | Ericca S Berry | Nurse Practitioner | 107 Dilworth St, Glendive, MT 59330-2053 | 2005-05-27 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on GEORGIA G MAYNARD.
| 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.