Provider Demographics
NPI:1598242372
Name:NOVA WOMEN'S HEALTH AND WELLNESS PLLC
Entity Type:Organization
Organization Name:NOVA WOMEN'S HEALTH AND WELLNESS PLLC
Other - Org Name:SHE HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PUTNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-577-2847
Mailing Address - Street 1:416 N 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3310
Mailing Address - Country:US
Mailing Address - Phone:406-577-2847
Mailing Address - Fax:406-577-2836
Practice Address - Street 1:416 N 7TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3310
Practice Address - Country:US
Practice Address - Phone:406-577-2847
Practice Address - Fax:406-577-2836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT43804261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty