Healthcare Provider Details

I. General information

NPI: 1184914087
Provider Name (Legal Business Name): BRIDGID ELIZABETH CROWLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 E BROADWAY ST
HELENA MT
59601-4905
US

IV. Provider business mailing address

PO BOX 6369
HELENA MT
59604-6369
US

V. Phone/Fax

Practice location:
  • Phone: 406-457-4180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberML60285239
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number70495
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: