Healthcare Provider Details

I. General information

NPI: 1730941733
Provider Name (Legal Business Name): LAUREN COLEY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 CRESTVIEW DR UNIT 204
BIGFORK MT
59911-3594
US

IV. Provider business mailing address

PO BOX 1826
BIGFORK MT
59911-1826
US

V. Phone/Fax

Practice location:
  • Phone: 406-210-2502
  • Fax: 406-730-6169
Mailing address:
  • Phone: 406-210-2502
  • Fax: 406-730-6169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number159303
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: