Healthcare Provider Details

I. General information

NPI: 1891959268
Provider Name (Legal Business Name): SUSAN M WENGER MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 24TH ST W
BILLINGS MT
59102
US

IV. Provider business mailing address

100 BROOKSHIRE BLVD, BUILDING 2, SUITE 1
BILLINGS MT
59102-6751
US

V. Phone/Fax

Practice location:
  • Phone: 406-702-1327
  • Fax:
Mailing address:
  • Phone: 406-384-6501
  • Fax: 406-206-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number23275
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23275
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: