Provider Demographics
NPI:1760112304
Name:PEACE OF MIND TELEHEALTH AND URGENT CARE LLC
Entity Type:Organization
Organization Name:PEACE OF MIND TELEHEALTH AND URGENT CARE LLC
Other - Org Name:LISA TURK
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:406-498-6183
Mailing Address - Street 1:48 BOE LN
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MT
Mailing Address - Zip Code:59759-9702
Mailing Address - Country:US
Mailing Address - Phone:406-498-6183
Mailing Address - Fax:
Practice Address - Street 1:48 BOE LN
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MT
Practice Address - Zip Code:59759-9702
Practice Address - Country:US
Practice Address - Phone:406-498-6183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1962940460Medicaid