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Individual

MRS. KIMBERLY LYNN LONGCAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
202 CONWAY DR STE 200, KALISPELL, MT 59901-3153
(844) 215-7969
(406) 758-7080
Mailing address
202 CONWAY DR STE 200, KALISPELL, MT 59901-3153
(844) 215-7969
(406) 758-7080

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
100423
MT
363LF0000X
Family Nurse Practitioner
991
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
162616
MEDICARE MD GROUP #
AK
05
NP05782
AK
Enumeration date
06/18/2007
Last updated
11/27/2023
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