Individual
MRS. JENIFER DARLENE CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1224 LINCOLN RD, MISSOULA, MT 59802-3041
(406) 241-3357
Mailing address
1224 LINCOLN RD, MISSOULA, MT 59802-3041
(406) 241-3357
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
576
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38508
WELLMARK BCBS
IA
Enumeration date
09/20/2005
Last updated
02/17/2011
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