Provider Demographics
NPI:1639322878
Name:BIGFORK FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:BIGFORK FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HELLWIG
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:406-837-4357
Mailing Address - Street 1:PO BOX 2944
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-2803
Mailing Address - Country:US
Mailing Address - Phone:406-837-4357
Mailing Address - Fax:406-837-3957
Practice Address - Street 1:7935 MT HIGHWAY 35
Practice Address - Street 2:SUITE 201
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-5709
Practice Address - Country:US
Practice Address - Phone:406-837-4357
Practice Address - Fax:406-837-3957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care