Healthcare Provider Details

I. General information

NPI: 1467656454
Provider Name (Legal Business Name): CINDY WELLS GWOZDZ NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2827 FORT MISSOULA RD
MISSOULA MT
59804-7408
US

IV. Provider business mailing address

2827 FORT MISSOULA RD
MISSOULA MT
59804-7408
US

V. Phone/Fax

Practice location:
  • Phone: 406-327-4058
  • Fax:
Mailing address:
  • Phone: 63-274-0584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number79561
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number1619221
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number104742
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: