Provider Demographics
NPI:1467608141
Name:HERCZEG, KATHERINE I (APRN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:I
Last Name:HERCZEG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:I
Other - Last Name:HERCZEG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:301 N 1ST ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2527
Mailing Address - Country:US
Mailing Address - Phone:406-414-7978
Mailing Address - Fax:406-414-7979
Practice Address - Street 1:301 N 1ST ST UNIT 3
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2527
Practice Address - Country:US
Practice Address - Phone:406-414-7978
Practice Address - Fax:406-414-7979
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT103381363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner