Healthcare Provider Details

I. General information

NPI: 1558042622
Provider Name (Legal Business Name): RYAN K HURSH APRN, CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 12TH AVE N STE 310W
BILLINGS MT
59101-7588
US

IV. Provider business mailing address

2900 12TH AVE N STE 310W
BILLINGS MT
59101-7588
US

V. Phone/Fax

Practice location:
  • Phone: 406-238-6900
  • Fax: 406-238-6939
Mailing address:
  • Phone: 406-238-6900
  • Fax: 406-238-6939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10355
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10355
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: