MEDICARE: JENNALIE DAWN GUTHMILLER FNP

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	363LF0000X	Family Nurse Practitioner	46425	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	46425	OTHER	MT	MT STATE RN LICENSE

General Provider Information

NPI Number	:	1629425467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNALIE DAWN GUTHMILLER FNP

Provider Business Mailing Address
First Line	:	1415 NORTHWEST BYP STE 1
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1710
Country	:	US
Telephone Number	:	406-781-6305
Fax Number	:	866-538-0274

Provider Business Practice Location Address
First Line	:	1415 NORTHWEST BYP STE 1
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1710
Country	:	US
Telephone Number	:	406-781-6305
Fax Number	:	866-538-0274

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

Provider Enumeration Date	:	05/23/2016
Last Update Date	:	02/18/2026

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