Healthcare Provider Details
I. General information
NPI: 1922930551
Provider Name (Legal Business Name): PNT WELLNESS: DIABETES & AESTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 12TH AVE S STE 101
GREAT FALLS MT
59405-5017
US
IV. Provider business mailing address
2300 12TH AVE S STE 101
GREAT FALLS MT
59405-5017
US
V. Phone/Fax
- Phone: 406-761-5252
- Fax: 406-761-3626
- Phone: 406-761-5252
- Fax: 406-761-3626
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAULINE
MARIE
CONWAY
Title or Position: PROVIDER
Credential: FNP
Phone: 406-799-3886