Provider Demographics
NPI:1215125729
Name:WILLIAMS, JENNIFER M (MPAS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:KUHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:SUITE 140W
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-238-6540
Mailing Address - Fax:406-238-6599
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 140W
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6540
Practice Address - Fax:406-238-6599
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT513363A00000X
MTMED-PAC-LIC-513363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000900863OtherBLUECROSS BLUESHIELD
MTP00472615OtherRAILROAD MEDICARE
MTP00472615OtherRAILROAD MEDICARE