Healthcare Provider Details

I. General information

NPI: 1508965369
Provider Name (Legal Business Name): JUNE NEELEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 W. MAIN STREET BOZEMAN HEALTH URGENT CARE
BOZEMAN MT
59715
US

IV. Provider business mailing address

1006 W MAIN ST
BOZEMAN MT
59715-3219
US

V. Phone/Fax

Practice location:
  • Phone: 406-586-8711
  • Fax:
Mailing address:
  • Phone: 406-414-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number67550
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: