Provider Demographics
NPI:1386425775
Name:WESTERN WELLNESS, LLC
Entity type:Organization
Organization Name:WESTERN WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTPHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-210-4072
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:MT
Mailing Address - Zip Code:59858-0306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:406-284-0234
Practice Address - Street 1:701 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:MT
Practice Address - Zip Code:59858-7700
Practice Address - Country:US
Practice Address - Phone:406-560-4074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty