Healthcare Provider Details
I. General information
NPI: 1104732056
Provider Name (Legal Business Name): CEDAR & SAGE HEALTH CLINIC & MEDSPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
107 W BELL ST
GLENDIVE MT
59330-1614
US
IV. Provider business mailing address
1405 E AMES WYE
GLENDIVE MT
59330-2001
US
V. Phone/Fax
- Phone: 406-939-2048
- Fax:
- Phone: 406-939-2048
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
CULVER
Title or Position: FAMILY NURSE PRACTITIONER
Credential: FNP
Phone: 406-939-2048