Healthcare Provider Details

I. General information

NPI: 1790697118
Provider Name (Legal Business Name): MICHELLE LYNN REYNOLDS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MT HIGHWAY 91 S
DILLON MT
59725-3535
US

IV. Provider business mailing address

25 LINCOLN DR
DILLON MT
59725-3432
US

V. Phone/Fax

Practice location:
  • Phone: 406-683-1118
  • Fax: 406-683-6891
Mailing address:
  • Phone: 406-683-1118
  • Fax: 406-683-6891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR-RN-LIC-192397
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: