Healthcare Provider Details
I. General information
NPI: 1780374983
Provider Name (Legal Business Name): KALEN MARIE GUNTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/10/2023
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1307 HARRISON AVE
BUTTE MT
59701-4801
US
IV. Provider business mailing address
PO BOX 208
ALDER MT
59710-0208
US
V. Phone/Fax
- Phone: 406-479-5092
- Fax: 406-479-5093
- Phone: 435-820-2007
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | PA-2747 |
| License Number State | ID |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | MED-PAC-LIC-136407 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: