| NPI | 1518983360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHIE S HENNEBERRY Sole Proprietor 406-234-8863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT RN26836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 4771) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2009-09-21 |