Healthcare Provider Details

I. General information

NPI: 1366922551
Provider Name (Legal Business Name): SHEILA ANN HURD PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA ANN HURD SHEILA COYLE

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35401 MISSION DR
SAINT IGNATIUS MT
59865-7791
US

IV. Provider business mailing address

1925 RAYMOND AVE
MISSOULA MT
59802-3513
US

V. Phone/Fax

Practice location:
  • Phone: 406-745-3525
  • Fax:
Mailing address:
  • Phone: 406-543-6317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number20773
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: