Individual
ELLEN S DEWOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN PC
Contact information
Practice address
125 BANK ST STE 310, MISSOULA, MT 59802-4413
(406) 549-7325
(406) 549-7559
Mailing address
PO BOX 3138, MISSOULA, MT 59806-3138
(406) 549-7325
(406) 549-7559
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN16128
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000098073
BC/BS
MT
05
—
4300153
—
MT
01
—
890000386
RAILROAD MEDICARE
MT
Enumeration date
08/22/2006
Last updated
10/10/2019
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