Provider Demographics
NPI:1114953734
Name:SIMENSEN, CATHLEEN ANN (WHCNP)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:ANN
Last Name:SIMENSEN
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 CRESTLINE AVE
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3558
Mailing Address - Country:US
Mailing Address - Phone:406-752-8282
Mailing Address - Fax:406-257-2225
Practice Address - Street 1:75 CLAREMONT ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3585
Practice Address - Country:US
Practice Address - Phone:406-752-8282
Practice Address - Fax:406-257-2225
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN10695363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4302360Medicaid
MTP29242Medicare UPIN