Healthcare Provider Details

I. General information

NPI: 1679990394
Provider Name (Legal Business Name): JADE KATHLEEN BARTOLETTI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JADE KATHLEEN JOHNSTONE R.N.

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 MADISON ST
SHERIDAN MT
59749-9636
US

IV. Provider business mailing address

PO BOX 336
SHERIDAN MT
59749-0336
US

V. Phone/Fax

Practice location:
  • Phone: 406-842-5453
  • Fax: 406-842-5057
Mailing address:
  • Phone: 406-842-5453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53490
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53490
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number217156
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-44958
License Number StateMT
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number53490
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: