Healthcare Provider Details

I. General information

NPI: 1497496939
Provider Name (Legal Business Name): KIRSTEN MICHELS MS, RD, LN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIRSTEN PFANNMULLER

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 S ROUSE AVE APT 8
BOZEMAN MT
59715-5766
US

IV. Provider business mailing address

2020 S ROUSE AVE APT 8
BOZEMAN MT
59715-5766
US

V. Phone/Fax

Practice location:
  • Phone: 208-631-8965
  • Fax:
Mailing address:
  • Phone: 208-631-8965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number108818
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: