Healthcare Provider Details

I. General information

NPI: 1003629312
Provider Name (Legal Business Name): KARA MEGHAN KNODEL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S 8TH AVE E
MALTA MT
59538-8978
US

IV. Provider business mailing address

271 CUT ACROSS RD
GLASGOW MT
59230-2806
US

V. Phone/Fax

Practice location:
  • Phone: 406-654-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number260113
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number97831
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: