Healthcare Provider Details

I. General information

NPI: 1982397139
Provider Name (Legal Business Name): ELKHORN TELEHEALTH PSYCHIATRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W HAUSER RD
BOULDER MT
59632-7706
US

IV. Provider business mailing address

PO BOX 785
BOULDER MT
59632-0785
US

V. Phone/Fax

Practice location:
  • Phone: 406-438-1829
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HEATHER NOEL ZUFELT
Title or Position: OWNER
Credential: APRN
Phone: 406-438-1829