Healthcare Provider Details

I. General information

NPI: 1144276635
Provider Name (Legal Business Name): VALERIE ANN KNUDSEN MD FACOG PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 FORT MISSOULA RD SUITE 306
MISSOULA MT
59804-7419
US

IV. Provider business mailing address

PO BOX 1130
HELENA MT
59624-1130
US

V. Phone/Fax

Practice location:
  • Phone: 406-327-4395
  • Fax: 406-327-4394
Mailing address:
  • Phone: 406-443-3076
  • Fax: 406-449-6531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5310
License Number StateMT

VIII. Authorized Official

Name: PAULA J HANIG
Title or Position: MEDICAL BILLING AGENT
Credential: CPC, CHBME
Phone: 406-443-3076