| NPI | 1023769973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY L MADDUX Sole Member Owner 406-561-3084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-02-18 |