Individual
MRS. JODEE MACDONALD ETCHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 N 29TH ST, BILLINGS, MT 59101-0905
(406) 238-2500
Mailing address
PO BOX 35100, BILLINGS, MT 59107-5100
(406) 238-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
322
MT
363AM0700X
Medical Physician Assistant
Primary
MED-PAC-LIC-322
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7096700
—
MT
01
—
P00673025
RR MEDICARE
MT
Enumeration date
09/09/2005
Last updated
12/14/2021
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