Healthcare Provider Details

I. General information

NPI: 1275965469
Provider Name (Legal Business Name): KRISTA LENA ELKINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 FARMHOUSE LANE
BOZEMAN MT
59715
US

IV. Provider business mailing address

T-9 FORT MISSOULA
MISSOULA MT
59804-7202
US

V. Phone/Fax

Practice location:
  • Phone: 406-522-7357
  • Fax: 406-522-8361
Mailing address:
  • Phone: 406-532-8400
  • Fax: 406-543-9316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number67742
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: