Healthcare Provider Details

I. General information

NPI: 1689793614
Provider Name (Legal Business Name): BUTTE FAMILY PLANNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W FRONT ST
BUTTE MT
59701-2801
US

IV. Provider business mailing address

25 W FRONT ST
BUTTE MT
59701-2801
US

V. Phone/Fax

Practice location:
  • Phone: 406-497-5080
  • Fax: 406-497-5099
Mailing address:
  • Phone: 406-497-5080
  • Fax: 406-497-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN14715
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN11730
License Number StateMT

VIII. Authorized Official

Name: TINA RANDALL
Title or Position: DIRECTOR
Credential:
Phone: 406-497-5001