Healthcare Provider Details

I. General information

NPI: 1114580701
Provider Name (Legal Business Name): MARTHA LEIGH NUGENT APRN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 S CENTRAL AVE
SIDNEY MT
59270-4940
US

IV. Provider business mailing address

813 S CENTRAL AVE
SIDNEY MT
59270-4940
US

V. Phone/Fax

Practice location:
  • Phone: 406-519-3446
  • Fax: 406-401-0144
Mailing address:
  • Phone: 406-393-5300
  • Fax: 406-401-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR52997
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNUR-APRN-LIC-149639
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: