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General NPI Number Information
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NPI Number | 1316519630
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Entity Type | Organization
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Legal Business Name | GREAT BEAR HEALTH
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 1077 WHITEFISH STAGE
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City | KALISPELL
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State | MT
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Zip | 59901-2735
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Country | US
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Telephone | 406-471-8139
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Fax | 888-701-1124
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Provider Business Mailing Address
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Address Line | 1077 WHITEFISH STAGE
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City | KALISPELL
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State | MT
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Zip | 59901-2735
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Country | US
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Telephone | 406-471-8139
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Fax | 888-701-8139
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Authorized Official
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Title or Position | APRN
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Name | LAURA H HUNTER
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Credential | APRN
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Telephone | 406-471-8139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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