Healthcare Provider Details

I. General information

NPI: 1326964727
Provider Name (Legal Business Name): KENDRA CLARK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 N 30TH ST
BILLINGS MT
59101-0127
US

IV. Provider business mailing address

333 MILES AVE
BILLINGS MT
59101-3049
US

V. Phone/Fax

Practice location:
  • Phone: 406-657-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number228515
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: