Healthcare Provider Details

I. General information

NPI: 1730005802
Provider Name (Legal Business Name): JODI HOUT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 PARK AVE
SHELBY MT
59474-1663
US

IV. Provider business mailing address

640 PARK AVE
SHELBY MT
59474-1663
US

V. Phone/Fax

Practice location:
  • Phone: 406-434-3209
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR-RN-LIC-216790
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: