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General NPI Number Information
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NPI Number | 1770294787
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Entity Type | Individual
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Provider Name | RAEANNA MADIGAN NP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 320 SUNNYVIEW LN
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City | KALISPELL
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State | MT
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Zip | 59901-3129
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Country | US
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Telephone | 406-752-7441
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Fax | 406-257-0304
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Provider Business Mailing Address
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Address Line | 58 SHAMROCK CT
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City | BILLINGS
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State | MT
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Zip | 59105-2361
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Country | US
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Telephone | 406-208-5997
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NUR-APRN-LIC-197257
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License Number State | MT
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