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General NPI Number Information
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NPI Number | 1598163750
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Entity Type | Individual
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Provider Name | LORI CHOVANAK KING DNP
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Gender | Female
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 2705 16TH AVE S
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City | GREAT FALLS
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State | MT
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Zip | 59405-5204
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Country | US
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Telephone | 406-459-1684
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Fax |
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Provider Business Mailing Address
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Address Line | 1257 E BRIGHTWATER LN
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City | BOISE
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State | ID
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Zip | 83706-6718
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Country | US
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Telephone | 406-459-1684
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA. 16855-NP
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License Number State | OH
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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 | NUR-RN-LIC-21384
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN100230
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License Number State | MT
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