Provider Demographics
NPI:1659979946
Name:BOZEMAN WELLNESS AND HEALTH LLC
Entity Type:Organization
Organization Name:BOZEMAN WELLNESS AND HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE-MIDWIFE AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:307-200-1476
Mailing Address - Street 1:601 W VILLARD ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3443
Mailing Address - Country:US
Mailing Address - Phone:406-585-0752
Mailing Address - Fax:
Practice Address - Street 1:601 W VILLARD ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3443
Practice Address - Country:US
Practice Address - Phone:406-585-0752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOZEMAN WELLNESS AND HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty