Healthcare Provider Details

I. General information

NPI: 1679494504
Provider Name (Legal Business Name): JENNIFER REID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER WIELAND

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 14TH AVE SW
SIDNEY MT
59270-3519
US

IV. Provider business mailing address

216 14TH AVE SW
SIDNEY MT
59270-3519
US

V. Phone/Fax

Practice location:
  • Phone: 406-488-2146
  • Fax:
Mailing address:
  • Phone: 406-488-2146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR-RN-LIC-68369
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: