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General NPI Number Information
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NPI Number | 1356420863
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Entity Type | Organization
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Legal Business Name | KATHLEEN A DOLEZAL APRN PC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 616 HELENA AVE
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City | HELENA
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State | MT
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Zip | 59601-3654
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Country | US
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Telephone | 406-495-7220
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Fax |
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Provider Business Mailing Address
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Address Line | 616 HELENA AVE STE 301
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City | HELENA
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State | MT
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Zip | 59601-3654
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Country | US
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Telephone | 406-442-3323
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Fax |
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Authorized Official
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Title or Position | MANAGER, BILLING COMPANY
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Name | NAOMI POCKLINGTON
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Credential |
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Telephone | 866-602-6822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 17403
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License Number State | MT
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