Organization · NPI-2
Four Corners Health Care INC
Nurse Practitioner, Pediatrics · Bozeman, MT
NPI number1245312644
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1245312644
- Entity type
- Organization (NPI-2)
- Legal business name
- Four Corners Health Care INC
- Organization subpart
- No
- Enumeration date
- Oct 19, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | RN20521 | MT | Yes |
| 363LF0000X | Nurse Practitioner, Family | RN20521 | MT |
Practice location
7720 Shedhorn Dr Ste DBozeman, MT 59718
Phone 406-556-8300 · Fax 406-556-8304
Mailing address
7720 Shedhorn Dr Ste DBozeman, MT 59718
Phone 406-556-8300 · Fax 406-556-8304
Authorized official
Marie Sills Mitchell
President Health Care Provider
4065568300
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