MEDICARE: JEANETTE HOUGHTELLING

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NUR-APRN-LIC-218336	MT

General Provider Information

NPI Number	:	1881386365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE HOUGHTELLING

Provider Business Mailing Address
First Line	:	115 COMMONS WAY STE 201
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-1906
Country	:	US
Telephone Number	:	406-270-9199
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 COMMONS WAY STE 201
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-1906
Country	:	US
Telephone Number	:	406-270-9199
Fax Number	:

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

Provider Enumeration Date	:	05/23/2023
Last Update Date	:	03/03/2026

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Directions to “ JEANETTE HOUGHTELLING ” Practice Location

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