Healthcare Provider Details

I. General information

NPI: 1912816729
Provider Name (Legal Business Name): TARA JANET WATKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YOUR HIGHNESS

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 SAINT JOHNS AVE
BILLINGS MT
59102-5518
US

IV. Provider business mailing address

1245 SAINT JOHNS AVE
BILLINGS MT
59102-5518
US

V. Phone/Fax

Practice location:
  • Phone: 406-200-5559
  • Fax:
Mailing address:
  • Phone: 406-200-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: