Organization
RAVALLI COUNTY
Active
Organization
RAVALLI COUNTY
Active
Parent organization
RAVALLI COUNTY
Other names
Ravalli County Public Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
RAVALLI COUNTY
Authorized official
MS. KIM A SQUIRES FNP/C (FAMILY NURSE PRACTITIONER)
(406) 375-6670
Entity
Organization
Contact information
Practice address
205 BEDFORD ST, SUITE L, HAMILTON, MT 59840-2853
(406) 375-6670
(406) 375-6680
Mailing address
205 BEDFORD ST, SUITE L, HAMILTON, MT 59840-2853
(406) 375-6670
(406) 375-6680
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
MS0194958
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13561
BLUE CROSS BLUE SHIELD
MT
01
—
31388
BCBS IZ'S
MT
05
—
350-0952
—
MT
01
—
94450094
MBCHP
MT
Enumeration date
08/02/2006
Last updated
03/12/2008
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