MEDICARE: BRENDA ROSE ARCHAMBAULT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1316824899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA ROSE ARCHAMBAULT

Provider Business Mailing Address
First Line	:	2500 7TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-3016
Country	:	US
Telephone Number	:	406-899-5148
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 7TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-3016
Country	:	US
Telephone Number	:	406-899-5148
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	10/30/2025

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Directions to “ BRENDA ROSE ARCHAMBAULT ” Practice Location

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