Provider Demographics
NPI:1114015617
Name:ALLMACHER, KERI F (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:F
Last Name:ALLMACHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 SOUTH AVE W
Mailing Address - Street 2:STE 402
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-6517
Mailing Address - Country:US
Mailing Address - Phone:406-543-8512
Mailing Address - Fax:406-541-8513
Practice Address - Street 1:1821 SOUTH AVE W
Practice Address - Street 2:STE 402
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6517
Practice Address - Country:US
Practice Address - Phone:406-541-8512
Practice Address - Fax:406-541-8513
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT329363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4308378Medicaid
MT97153OtherBCBS
MTP81214Medicare UPIN