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General NPI Number Information
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NPI Number | 1578574067
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Entity Type | Individual
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Provider Name | DIANNE WICKHAM SAWITKE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 530 N MONTANA ST TRINA HEALTH OF MONTANA
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City | DILLON
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State | MT
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Zip | 59725-3315
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Country | US
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Telephone | 406-988-0721
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Fax | 406-988-0724
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Provider Business Mailing Address
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Address Line | 530 N MONTANA ST TRINA HEALTH OF MONTANA
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City | DILLON
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State | MT
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Zip | 59725-3315
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Country | US
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Telephone | 406-988-0721
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Fax | 406-988-0724
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NUR-APRN-LIC-100581
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License Number State | MT
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Taxonomy #2
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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-100581
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License Number State | MT
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