Individual
KRISTY EHRMANTRAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
60 FOUR MILE DR STE 11, KALISPELL, MT 59901-2663
(406) 609-0210
(406) 609-0211
Mailing address
60 FOUR MILE DR STE 11, KALISPELL, MT 59901-2663
(406) 609-0210
(406) 609-0211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
620
MT
363AS0400X
Surgical Physician Assistant
004673
GA
363AS0400X
Surgical Physician Assistant
620
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004673
P.A. LICENSE
GA
01
—
620
MONTANA LICENSE
MT
Enumeration date
08/29/2006
Last updated
01/20/2023
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