Organization
SHAMROCK FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHIE S HENNEBERRY ENP (SOLE PROPRIETOR)
(406) 234-8863
Entity
Organization
Contact information
Practice address
2000 CLARK ST, MILES CITY, MT 59301-2726
(406) 234-3824
(406) 234-1041
Mailing address
PO BOX 579, MILES CITY, MT 59301-0579
(406) 234-3824
(406) 234-1041
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4771
MT
363L00000X
Nurse Practitioner
Primary
RN26836
MT
Other
Enumeration date
07/14/2006
Last updated
09/21/2009
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