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Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1073823845

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1101 26TH ST S  GREAT FALLS, MT 59405-5161 US
Tel: 406-731-8800  Fax: --

Contact information for business:
1711 W KOCH ST APT 43  BOZEMAN, MT 59715-4198 US
Tel: 406-581-7887  Fax: --

Registration Information:
NPI: 1073823845
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant

Legacy codes, insurance codes and state license numbers:



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