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General NPI Number Information
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NPI Number | 1205667276
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Entity Type | Organization
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Legal Business Name | MAGIC CITY FAMILY MEDICINE INC
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Dates
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Enumeration Date | 08/12/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 901 WYOMING AVE SUITE 901
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City | BILLINGS
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State | MT
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Zip | 59101
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Country | US
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Telephone | 406-788-3432
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 24TH ST. W PMB 142
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City | BILLINGS
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State | MT
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Zip | 59102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, FAMILY NURSE PRACTITIONER
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Name | KRISTY MARTIN
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Credential | FNP
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Telephone | 406-788-3432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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