Healthcare Provider Details

I. General information

NPI: 1881405710
Provider Name (Legal Business Name): NICHOLIA SEAHOLM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICHOLIA WALKER RN

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2291 CABALLO AVE STE 1
BOZEMAN MT
59718-5657
US

IV. Provider business mailing address

2291 CABALLO AVE STE 1
BOZEMAN MT
59718-5657
US

V. Phone/Fax

Practice location:
  • Phone: 406-624-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-291685
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: