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General NPI Number Information
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NPI Number | 1821013160
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Entity Type | Individual
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Provider Name | CYNTHIA ROWE BACON NP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 931 HIGHLAND BLVD STE 3130
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City | BOZEMAN
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State | MT
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Zip | 59715-6914
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Country | US
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Telephone | 406-414-5070
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Fax |
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Provider Business Mailing Address
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Address Line | 915 HIGHLAND BLVD
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City | BOZEMAN
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State | MT
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Zip | 59715-6902
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Country | US
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Telephone | 406-414-1044
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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 | 2005010399-22
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NUR-APRN-LIC-160035
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 05-01633
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License Number State | NC
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