Organization
PREMIER CARE PEDIATRICS & FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL SIMMONS (OFFICE MANAGER)
(406) 455-5437
Entity
Organization
Contact information
Practice address
1300 28TH ST S, SUITE 6, GREAT FALLS, MT 59405-5296
(406) 455-5437
(406) 455-4365
Mailing address
1300 28TH ST S, SUITE 6, GREAT FALLS, MT 59405-5296
(406) 455-5437
(406) 455-4365
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
8726
MT
363LF0000X
Family Nurse Practitioner
APN13634
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117062
—
MT
Enumeration date
09/17/2010
Last updated
09/17/2010
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