Provider Demographics
NPI:1689305328
Name:TEAKETTLE WOMEN'S WELLNESS, LLC
Entity Type:Organization
Organization Name:TEAKETTLE WOMEN'S WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:406-205-3111
Mailing Address - Street 1:6 9TH ST E STE 305
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-3701
Mailing Address - Country:US
Mailing Address - Phone:406-205-3111
Mailing Address - Fax:
Practice Address - Street 1:6 9TH ST E STE 305
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-3701
Practice Address - Country:US
Practice Address - Phone:406-205-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty