Individual
TARA JANE WILLOUGHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
81 W PARK ST, BUTTE, MT 59701-1713
(406) 497-9000
(406) 723-7117
Mailing address
1321 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-8400
(406) 224-4402
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
142868
MT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
142868
MT
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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