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NPI Code Detail

MEDICARE: DOREEN KENFIELD PAC

MEDICARE: DOREEN KENFIELD PAC
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
1363A00000XPhysician Assistant552MT
2363AS0400XSurgical Physician AssistantMED-PAC-LIC-552MT

General Provider Information

NPI Number : 1871746172
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOREEN KENFIELD PAC
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 : 760 WICKS LN
Second Line :
City : BILLINGS
State : MT
Zip : 59105-4427
Country : US
Telephone Number : 406-238-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2008
Last Update Date : 12/14/2021

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Directions to “ DOREEN KENFIELD PAC” Practice Location

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