Provider Demographics
NPI:1902208127
Name:ESPRIT HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:ESPRIT HEALTH AND WELLNESS, LLC
Other - Org Name:ESPRIT HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TRUDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, CNP
Authorized Official - Phone:406-488-5000
Mailing Address - Street 1:309 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-4127
Mailing Address - Country:US
Mailing Address - Phone:406-488-5000
Mailing Address - Fax:406-206-0193
Practice Address - Street 1:309 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-4127
Practice Address - Country:US
Practice Address - Phone:406-488-5000
Practice Address - Fax:406-206-0193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT32580363L00000X
363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty