Healthcare Provider Details

I. General information

NPI: 1851494744
Provider Name (Legal Business Name): PATTY GIERKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 MISSION DRIVE
ST. IGNATIUS MT
59865
US

IV. Provider business mailing address

PO BOX 880 MISSION DRIVE
ST. IGNATIUS MT
59865
US

V. Phone/Fax

Practice location:
  • Phone: 406-745-3525
  • Fax: 406-745-4091
Mailing address:
  • Phone: 406-745-3525
  • Fax: 406-745-4091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN13079
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: