Provider Demographics
NPI:1467608141
Name:HERCZEG, KATHERINE I (APRN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:I
Last Name:HERCZEG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:I
Other - Last Name:HERCZEG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:2950 S 21ST AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-5042
Mailing Address - Country:US
Mailing Address - Phone:706-957-2633
Mailing Address - Fax:
Practice Address - Street 1:2950 S 21ST AVE APT 106
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5042
Practice Address - Country:US
Practice Address - Phone:706-957-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT103381363LP2300X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care