Healthcare Provider Details

I. General information

NPI: 1629634670
Provider Name (Legal Business Name): NATALIE JEAN VAN HOUTEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 KNAPP ST
WOLF POINT MT
59201-1826
US

IV. Provider business mailing address

301 KNAPP ST
WOLF POINT MT
59201-1826
US

V. Phone/Fax

Practice location:
  • Phone: 406-653-6500
  • Fax:
Mailing address:
  • Phone: 406-653-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNUR-APRN-LIC-177686
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60865803
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: