Healthcare Provider Details

I. General information

NPI: 1073401881
Provider Name (Legal Business Name): MICHELE NOELLE GEPPERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 SILVERADO TRL
BIG SKY MT
59716-7880
US

IV. Provider business mailing address

PO BOX 161766
BIG SKY MT
59716-1766
US

V. Phone/Fax

Practice location:
  • Phone: 406-599-7075
  • Fax:
Mailing address:
  • Phone: 406-599-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-265166
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: