Provider Demographics
NPI:1437736907
Name:PEALE, PATIENCE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:MARIE
Last Name:PEALE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PATIENCE
Other - Middle Name:MARIE
Other - Last Name:KASUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4655 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-6966
Mailing Address - Country:US
Mailing Address - Phone:406-782-5598
Mailing Address - Fax:
Practice Address - Street 1:4655 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-6966
Practice Address - Country:US
Practice Address - Phone:406-782-5598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-174686363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health