| NPI | 1528856580 |
|---|---|
| Former Legal Business Name | NURSE PRACTITIONER, OWNER |
| Entity Type | Organization |
| Authorized Contact | RACHELLE WAYDENE RODRIGUEZ Nurse Practitioner / Owner 406-241-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-05-16 |