Healthcare Provider Details

I. General information

NPI: 1134045727
Provider Name (Legal Business Name): MS. TAYLEE RAYNE TOLZIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 SOUTH 5TH STREET EAST #21
BAKER MT
59313
US

IV. Provider business mailing address

107 SOUTH 5TH STREET EAST #21
BAKER MT
59313
US

V. Phone/Fax

Practice location:
  • Phone: 406-345-3306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberNUR-RN-LIC-239969
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: