Healthcare Provider Details

I. General information

NPI: 1144766031
Provider Name (Legal Business Name): BRANDY JO HILDE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 3RD AVENUE EAST N
KALISPELL MT
59901-4109
US

IV. Provider business mailing address

5981 MT HIGHWAY 35
BIGFORK MT
59911-6015
US

V. Phone/Fax

Practice location:
  • Phone: 406-257-1397
  • Fax:
Mailing address:
  • Phone: 907-738-9253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA-PHA-LIC-39595
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: