Healthcare Provider Details

I. General information

NPI: 1790138121
Provider Name (Legal Business Name): AMELIA LEE DURLING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 11/27/2023
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HERITAGE WAY STE 102
KALISPELL MT
59901-3127
US

IV. Provider business mailing address

160 HERITAGE WAY STE 102
KALISPELL MT
59901-3127
US

V. Phone/Fax

Practice location:
  • Phone: 406-758-3244
  • Fax: 406-758-5166
Mailing address:
  • Phone: 406-758-3244
  • Fax: 406-758-5166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7816
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number87116
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: