MEDICARE: KRISTEN L PREWITT DO

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	207Q00000X	Family Medicine Physician	54952	WI
2	207Q00000X	Family Medicine Physician	23746	MT

General Provider Information

NPI Number	:	1396979118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN L PREWITT DO

Provider Business Mailing Address
First Line	:	PO BOX 35100
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59107-5100
Country	:	US
Telephone Number	:	406-238-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3905 WELLNESS WAY
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-2402
Country	:	US
Telephone Number	:	406-898-1200
Fax Number	:

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

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	03/30/2023

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