Healthcare Provider Details

I. General information

NPI: 1194704437
Provider Name (Legal Business Name): VALERIE A KNUDSEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/08/2007
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:
Title or Position:
Credential:
Phone: