Healthcare Provider Details

I. General information

NPI: 1881521615
Provider Name (Legal Business Name): CHERRY CREEK AESTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 1ST AVE S
GLASGOW MT
59230-2310
US

IV. Provider business mailing address

271 CUT ACROSS RD
GLASGOW MT
59230-2806
US

V. Phone/Fax

Practice location:
  • Phone: 406-263-8552
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. KARA MEGHAN KNODEL
Title or Position: OWNER, AESTHETIC NURSE PRACTITIONER
Credential: FNP-C
Phone: 406-263-8552