Healthcare Provider Details

I. General information

NPI: 1639474943
Provider Name (Legal Business Name): KIMBERLY ANN WALTERS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 VANDELAY AVE
HELENA MT
59601-3929
US

IV. Provider business mailing address

PO BOX 927
BOULDER MT
59632-0927
US

V. Phone/Fax

Practice location:
  • Phone: 406-389-2513
  • Fax:
Mailing address:
  • Phone: 509-710-0552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA-PHA-LIC-4752
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: