Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health & Services Mt

Organization Nurse Practitioner · NPI 1174074827

Providence Health & Services Mt is a Nurse Practitioner in Missoula, Montana. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

500 W Broadway St
Missoula, MT 59802-4008
Phone: (406) 543-7271
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1174074827
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Health Express
NPI enumeratedOctober 18, 2016
Last updated in NPPESMay 5, 2025
Certification dateMay 5, 2025
Mailing addressPo Box 12, Liberty Lake, WA 99019-0012

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