Healthcare Provider Details

I. General information

NPI: 1285079913
Provider Name (Legal Business Name): ASHTON S HOFSTAD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 SUNSET BLVD
CONRAD MT
59425-1717
US

IV. Provider business mailing address

809 SUNSET BLVD
CONRAD MT
59425-1799
US

V. Phone/Fax

Practice location:
  • Phone: 406-271-3211
  • Fax: 406-271-3917
Mailing address:
  • Phone: 406-271-3231
  • Fax: 406-271-3576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39699
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-100845
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: