=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376484923
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILD GINGER WELLNESS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2026
-----------------------------------------------------
Last Update Date | 04/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 GILLIS RD
-----------------------------------------------------
City | CUT BANK
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59427-9030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-845-5335
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2093
-----------------------------------------------------
City | CUT BANK
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59427-2093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ASHLEY TIPPENS
-----------------------------------------------------
Credential | RDN, LN
-----------------------------------------------------
Telephone | 406-845-5335
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------