Provider Demographics
NPI:1710338892
Name:CONWAY, PAULINE MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:MARIE
Last Name:CONWAY
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 1:115 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3618
Mailing Address - Country:US
Mailing Address - Phone:406-454-6950
Mailing Address - Fax:406-761-9898
Practice Address - Street 1:115 4TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3618
Practice Address - Country:US
Practice Address - Phone:406-454-6950
Practice Address - Fax:406-761-9898
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily