Healthcare Provider Details

I. General information

NPI: 1811098981
Provider Name (Legal Business Name): KATHY PALM JORGENSEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 9TH ST S
GREAT FALLS MT
59401
US

IV. Provider business mailing address

2525 4TH AVENUE NORTH SUITE 201
BILLINGS MT
59101
US

V. Phone/Fax

Practice location:
  • Phone: 406-454-3431
  • Fax: 406-454-3433
Mailing address:
  • Phone: 406-248-3637
  • Fax: 406-254-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN11415
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: