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General NPI Number Information
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NPI Number | 1285251496
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Entity Type | Individual
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Provider Name | CARLY JORDAN HATFIELD DNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 210 N HIGGINS AVE STE 314
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City | MISSOULA
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State | MT
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Zip | 59802-4443
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Country | US
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Telephone | 406-851-9244
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8744
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City | MISSOULA
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State | MT
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Zip | 59807-8744
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Country | US
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Telephone | 406-851-9244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NUR-APRN-LIC-160820
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | NUR-RN-LIC-126877
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License Number State | MT
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