Healthcare Provider Details

I. General information

NPI: 1831341296
Provider Name (Legal Business Name): 4 MY KIDS FAMILY PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 INDIAN TRAIL RD
KALISPELL MT
59901-2613
US

IV. Provider business mailing address

95 INDIAN TRAIL RD
KALISPELL MT
59901-2613
US

V. Phone/Fax

Practice location:
  • Phone: 406-755-6774
  • Fax:
Mailing address:
  • Phone: 406-755-6774
  • Fax: 406-257-2706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHY JEAN BRONSON
Title or Position: FAMILY PRACTITIONER
Credential: FNPC
Phone: 406-755-6774