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Contact Information

PROVIDENCE HEALTH & SERVICES MT
500 W BROADWAY ST
MISSOULA, MT59802-4096
 Phone: 406-327-1613
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Hospitalist

208M00000X
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH SERVICES MT · (Female)

NPI # 1154562981
Status Active
Credentials
Entity Individual
Enumeration date 03/06/2009
Last updated 05/06/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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