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General NPI Number Information
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NPI Number | 1619372364
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Entity Type | Individual
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Provider Name | MADONNA GARTRELL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 6 13TH AVE E
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City | POLSON
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State | MT
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Zip | 59860-5315
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Country | US
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Telephone | 406-883-5680
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31001 4114
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City | PASADENA
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State | CA
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Zip | 91110-4114
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Country | US
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Telephone | 406-883-5680
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Fax | 406-883-8910
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NUR-APRN-LIC-266525
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | APRN-266525
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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