Provider Demographics
NPI:1942623178
Name:IRENE WALTERS FAMILY PSYCHIATRY PC
Entity Type:Organization
Organization Name:IRENE WALTERS FAMILY PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN - FAMILY PSYCHI
Authorized Official - Phone:406-375-7522
Mailing Address - Street 1:99 MARCUS STREET
Mailing Address - Street 2:SUITE C4
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840
Mailing Address - Country:US
Mailing Address - Phone:406-375-7522
Mailing Address - Fax:406-375-7542
Practice Address - Street 1:99 MARCUS STREET
Practice Address - Street 2:SUITE C4
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840
Practice Address - Country:US
Practice Address - Phone:406-375-7522
Practice Address - Fax:406-375-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty