Individual
KEITH MCDIVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
760 HOSPITAL CIRCLE, BLACKFEET SERVICE UNIT, BROWNING, MT 59417-3630
(406) 338-6136
Mailing address
114 4TH ST SW, CUT BANK, MT 59427-3630
(406) 873-9157
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
363LOOOOOX
MT
Other
Enumeration date
12/22/2006
Last updated
07/09/2007
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