MEDICARE: JUDY A GILMAN NP

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	RN7426	MT

General Provider Information

NPI Number	:	1881691400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY A GILMAN NP

Provider Business Mailing Address
First Line	:	805 HOWARD ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59804-1903
Country	:	US
Telephone Number	:	406-546-7819
Fax Number	:	406-728-4919

Provider Business Practice Location Address
First Line	:	805 HOWARD ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59804-1903
Country	:	US
Telephone Number	:	406-546-7819
Fax Number	:	406-728-4919

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

Provider Enumeration Date	:	06/29/2005
Last Update Date	:	03/07/2023

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