Provider Demographics
NPI:1972215747
Name:THE OFFICE OF KRISTIN MCCOLLY NP PLLC
Entity type:Organization
Organization Name:THE OFFICE OF KRISTIN MCCOLLY NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-648-5432
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:MT
Mailing Address - Zip Code:59241-0002
Mailing Address - Country:US
Mailing Address - Phone:406-648-5432
Mailing Address - Fax:406-648-5430
Practice Address - Street 1:724 4TH AVE NORTH
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:MT
Practice Address - Zip Code:59241-0002
Practice Address - Country:US
Practice Address - Phone:406-648-5432
Practice Address - Fax:406-648-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT9902750Medicaid