Healthcare Provider Details

I. General information

NPI: 1295593119
Provider Name (Legal Business Name): ASHLEY MICHELE CAMPBELL ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 28TH ST S FL 2
GREAT FALLS MT
59405-5296
US

IV. Provider business mailing address

PO BOX 6010
GREAT FALLS MT
59406-6010
US

V. Phone/Fax

Practice location:
  • Phone: 406-455-4320
  • Fax:
Mailing address:
  • Phone: 406-455-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNUR-APRN-LIC-235656
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR-RN-LIC-170538
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: