Healthcare Provider Details

I. General information

NPI: 1124838149
Provider Name (Legal Business Name): ASHLYN MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 RED BARN DR
BELGRADE MT
59714-9292
US

IV. Provider business mailing address

169 RED BARN DR
BELGRADE MT
59714-9292
US

V. Phone/Fax

Practice location:
  • Phone: 406-600-7225
  • Fax:
Mailing address:
  • Phone: 406-600-7225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number292302
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: