Healthcare Provider Details

I. General information

NPI: 1932936176
Provider Name (Legal Business Name): KARI JEAN GILLEN PMHNP, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 ZIMMERMAN TRL
BILLINGS MT
59102-7652
US

IV. Provider business mailing address

4344 LEVANG LN
BILLINGS MT
59105-5148
US

V. Phone/Fax

Practice location:
  • Phone: 406-248-3607
  • Fax:
Mailing address:
  • Phone: 218-780-0576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNUR-APRN-LIC-243054
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: