Healthcare Provider Details

I. General information

NPI: 1013083930
Provider Name (Legal Business Name): COUNTY OF SHERIDAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W LAUREL AVE
PLENTYWOOD MT
59254-1647
US

IV. Provider business mailing address

100 W LAUREL AVE
PLENTYWOOD MT
59254-1647
US

V. Phone/Fax

Practice location:
  • Phone: 406-765-3410
  • Fax: 406-765-3495
Mailing address:
  • Phone: 406-765-3410
  • Fax: 406-765-3495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateMT

VIII. Authorized Official

Name: KATHLEEN FRANCES JENSEN
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: RN
Phone: 406-765-3410