MEDICARE: TROY DENNIS WARLING FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	200550091NP	OR
2	363LF0000X	Family Nurse Practitioner	33092	MT

General Provider Information

NPI Number	:	1053304378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY DENNIS WARLING FNP

Provider Business Mailing Address
First Line	:	2825 FORT MISSOULA RD
Second Line	:	SUITE 121
City	:	MISSOULA
State	:	MT
Zip	:	59804-7420
Country	:	US
Telephone Number	:	406-926-3500
Fax Number	:	406-926-3498

Provider Business Practice Location Address
First Line	:	2835 FORT MISSOULA RD
Second Line	:	PHYSICIAN CENTER 3, SUITE 204
City	:	MISSOULA
State	:	MT
Zip	:	59804-7423
Country	:	US
Telephone Number	:	406-327-3935
Fax Number	:	406-327-3933

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	09/10/2014

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