Provider Demographics
NPI:1447337852
Name:LOZANO, REBECCA L (RN, MSN, GNP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:L
Last Name:LOZANO
Suffix:
Gender:F
Credentials:RN, MSN, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 2ND AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2608
Mailing Address - Country:US
Mailing Address - Phone:406-781-8152
Mailing Address - Fax:406-771-8346
Practice Address - Street 1:603 14TH ST SW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-2633
Practice Address - Country:US
Practice Address - Phone:406-799-9747
Practice Address - Fax:888-786-3099
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-45243363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1447337852Medicaid
MT1447337852Medicaid
MTM011001699Medicare PIN