Provider Demographics
NPI:1972973477
Name:OHL, THERESA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:OHL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S 8TH AVE E
Mailing Address - Street 2:PO BOX 640
Mailing Address - City:MALTA
Mailing Address - State:MT
Mailing Address - Zip Code:59538-8978
Mailing Address - Country:US
Mailing Address - Phone:406-654-1800
Mailing Address - Fax:406-654-2876
Practice Address - Street 1:311 S 8TH AVE E
Practice Address - Street 2:311 S. 8TH AVE E
Practice Address - City:MALTA
Practice Address - State:MT
Practice Address - Zip Code:59538-8978
Practice Address - Country:US
Practice Address - Phone:406-654-1800
Practice Address - Fax:406-654-2876
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-28429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily