Provider Demographics
NPI:1407683204
Name:ENGLESON, KAY ANN (RN)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:ANN
Last Name:ENGLESON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:ANN
Other - Last Name:HABEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:MT
Mailing Address - Zip Code:59530-0872
Mailing Address - Country:US
Mailing Address - Phone:406-301-4071
Mailing Address - Fax:
Practice Address - Street 1:ROCKY BOY HEALTH CENTER
Practice Address - Street 2:6850 UPPER BOX ELDER RD
Practice Address - City:BOX ELDER
Practice Address - State:MT
Practice Address - Zip Code:59521
Practice Address - Country:US
Practice Address - Phone:406-395-4486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-239513163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse