Provider Demographics
NPI:1114649639
Name:TAYLER RYDALCH PMHNP-BC, LLC
Entity Type:Organization
Organization Name:TAYLER RYDALCH PMHNP-BC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:TAYLER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RYDALCH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:406-646-2470
Mailing Address - Street 1:84 OHIO ST
Mailing Address - Street 2:STE 6
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1806
Mailing Address - Country:US
Mailing Address - Phone:406-646-2470
Mailing Address - Fax:406-299-3911
Practice Address - Street 1:209 S MONTANA ST STE B7
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1679
Practice Address - Country:US
Practice Address - Phone:406-646-2470
Practice Address - Fax:406-299-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty