Individual
GRETCHEN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
320 ALPENGLOW LN, LIVINGSTON, MT 59047-8506
(406) 222-3541
Mailing address
320 ALPENGLOW LN, LIVINGSTON, MT 59047-8506
(610) 212-6936
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
127586
MT
363LF0000X
Family Nurse Practitioner
Primary
158939
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127586
MT BON
MT
Enumeration date
03/06/2020
Last updated
04/30/2020
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