Individual
ELIZABETH ANN CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1255 W SIDE BLVD, BUTTE, MT 59701-2209
(406) 490-9664
Mailing address
1255 W SIDE BLVD, BUTTE, MT 59701-2209
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-165085
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NUR-APRN-LIC-165085
—
MT
Enumeration date
11/13/2020
Last updated
05/26/2021
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