| NPI | 1528785342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LAURA SHIPLEY Nurse Practitioner 406-318-6306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2026-01-13 |