Individual
KRYSTIN DANIELLE NUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
305 N MAIN ST, ENNIS, MT 59729-8001
(406) 682-6862
(406) 682-4756
Mailing address
305 N MAIN ST, ENNIS, MT 59729-8001
(406) 682-4223
(406) 682-3874
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
126210
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00726312
—
MS
01
—
302I503659
MEDICARE PTAN
MS
Enumeration date
10/21/2009
Last updated
06/29/2021
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