Basic Information
Provider Information
NPI: 1801863261
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EVERSON
FirstName: MARJORIE
MiddleName: GEISZ
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1101 26TH ST S
Address2:  
City: GREAT FALLS
State: MT
PostalCode: 594055161
CountryCode: US
TelephoneNumber: 4067318888
FaxNumber: 4067318888
Practice Location
Address1: 1101 26TH ST S
Address2:  
City: GREAT FALLS
State: MT
PostalCode: 594055161
CountryCode: US
TelephoneNumber: 4067318888
FaxNumber: 4067318876
Other Information
ProviderEnumerationDate: 03/03/2006
LastUpdateDate: 11/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X131456MTY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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