Provider Demographics
NPI:1366496986
Name:EDWARDS, KATHERINE TRAHAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:TRAHAN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:T
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:104 W CUSTER AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0106
Mailing Address - Country:US
Mailing Address - Phone:406-513-1138
Mailing Address - Fax:406-513-1139
Practice Address - Street 1:104 W CUSTER AVE STE 6
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0106
Practice Address - Country:US
Practice Address - Phone:406-513-1138
Practice Address - Fax:406-513-1139
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR28603363LF0000X
MTNUR-APRN-LIC-100927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDQ56391Medicare UPIN