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NPI Code Detail

MEDICARE: HEATHER LYNN SMITH BSN, MSN

MEDICARE: HEATHER LYNN SMITH BSN, MSN
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
1363L00000XNurse Practitioner146938MT

General Provider Information

NPI Number : 1750911962
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER LYNN SMITH BSN, MSN
Provider Business Mailing Address
First Line : 1518 CHOUTEAU ST
Second Line :
City : FORT BENTON
State : MT
Zip : 59442-9003
Country : US
Telephone Number : 406-622-5485
Fax Number : 406-622-5670
Provider Business Practice Location Address
First Line : 1518 CHOUTEAU ST
Second Line :
City : FORT BENTON
State : MT
Zip : 59442-9003
Country : US
Telephone Number : 406-622-5485
Fax Number : 406-622-5670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2020
Last Update Date : 05/09/2023

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