Healthcare Provider Details

I. General information

NPI: 1841823671
Provider Name (Legal Business Name): JENNIFER ANNE METCALFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ANNE PITT

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 AIRPORT RD
KALISPELL MT
59901-7504
US

IV. Provider business mailing address

1035 1ST AVE W
KALISPELL MT
59901-5607
US

V. Phone/Fax

Practice location:
  • Phone: 406-300-0600
  • Fax:
Mailing address:
  • Phone: 406-751-8113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: