MEDICARE: CARMEN KAY STAIGMILLER FNP-C

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	23661	MT

General Provider Information

NPI Number	:	1508172719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN KAY STAIGMILLER FNP-C

Provider Business Mailing Address
First Line	:	201 1ST AVE N
Second Line	:	PO BOX 37
City	:	FAIRFIELD
State	:	MT
Zip	:	59436-0037
Country	:	US
Telephone Number	:	406-467-3447
Fax Number	:	406-467-3407

Provider Business Practice Location Address
First Line	:	201 1ST AVE N
Second Line	:
City	:	FAIRFIELD
State	:	MT
Zip	:	59436-9245
Country	:	US
Telephone Number	:	406-467-3447
Fax Number	:	406-467-3407

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

Provider Enumeration Date	:	08/25/2010
Last Update Date	:	09/01/2021

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