Healthcare Provider Details

I. General information

NPI: 1326929175
Provider Name (Legal Business Name): CONNIE JO LARD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 BURNS WAY
KALISPELL MT
59901-3110
US

IV. Provider business mailing address

1563 FOYS LAKE RD
KALISPELL MT
59901-7410
US

V. Phone/Fax

Practice location:
  • Phone: 406-755-5266
  • Fax: 406-755-0228
Mailing address:
  • Phone: 406-249-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number267745
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: