Provider Demographics
NPI:1558428656
Name:WALTON, SARAH (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WALTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1228
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-1228
Mailing Address - Country:US
Mailing Address - Phone:406-932-4603
Mailing Address - Fax:406-932-5468
Practice Address - Street 1:701 STOCK ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011
Practice Address - Country:US
Practice Address - Phone:406-932-4199
Practice Address - Fax:406-932-5468
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000037455OtherBCBS
MT0434798Medicaid
MT0434798Medicaid
S36090Medicare UPIN