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Individual

LILY AVGUSTOVSKIY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1401 25TH ST S, GREAT FALLS, MT 59405-5183
(406) 731-8888
Mailing address
1401 25TH ST S, GREAT FALLS, MT 59405-5183
(406) 731-8888

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
102646
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18904
APN
TN
Enumeration date
07/18/2014
Last updated
09/13/2021
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