Healthcare Provider Details

I. General information

NPI: 1023281102
Provider Name (Legal Business Name): JENNIFER LYNN SMALL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER SMALL-PARKER RN

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 02/12/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROCKY BOY HEALTH CENTER 6850 UPPER BOX ELDER RD
BOX ELDER MT
59501
US

IV. Provider business mailing address

620 13TH ST W APT 11
HAVRE MT
59501-4808
US

V. Phone/Fax

Practice location:
  • Phone: 406-395-4486
  • Fax:
Mailing address:
  • Phone: 406-390-1250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number23637
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: