Healthcare Provider Details

I. General information

NPI: 1710960554
Provider Name (Legal Business Name): TAMMY L RALSTON APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 UPPER BOX ELDER RD
BOX ELDER MT
59521-9073
US

IV. Provider business mailing address

6850 UPPER BOX ELDER RD
BOX ELDER MT
59521-9073
US

V. Phone/Fax

Practice location:
  • Phone: 406-395-4818
  • Fax: 406-395-4399
Mailing address:
  • Phone: 406-395-4818
  • Fax: 406-395-4399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number96754
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: