Evan Callos Boncolmo, RN is a
Registered Nurse based in Glendive, Montana. Evan Callos Boncolmo is licensed to practice in California (license number 95312691) and his current practice location is
806 N Kendrick Ave, Glendive, Montana. He can be reached at his office (for appointments etc.) via phone at
(161) 575-3110.
NPI number for Evan Callos Boncolmo is 1699590828 and his current mailing address is 806 N Kendrick Ave, Glendive, Montana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1699590828.
Provider's Profile
Full Name | Evan Callos Boncolmo |
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Gender | Male |
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Speciality | Registered Nurse |
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Location | 806 N Kendrick Ave, Glendive, Montana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1699590828
- Provider Enumeration Date: 11/21/2024
- Last Update Date: 11/21/2024
Medical Identifiers
Medical identifiers for Evan Callos Boncolmo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699590828 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 95312691 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evan Callos Boncolmo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Evan Callos Boncolmo, RN 806 N Kendrick Ave, Glendive, MT 59330-1819 Ph: (615) 753-1107 | Evan Callos Boncolmo, RN 806 N Kendrick Ave, Glendive, MT 59330-1819 Ph: (161) 575-3110 |
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