Provider Demographics
NPI:1356754717
Name:PELROY, PAUL (ARNP)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:PELROY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2510
Mailing Address - Country:US
Mailing Address - Phone:406-454-6973
Mailing Address - Fax:406-791-9277
Practice Address - Street 1:19 1ST ST NE
Practice Address - Street 2:
Practice Address - City:CHOTEAU
Practice Address - State:MT
Practice Address - Zip Code:59422-9275
Practice Address - Country:US
Practice Address - Phone:406-466-5165
Practice Address - Fax:406-466-2436
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60475275363LF0000X
MTNUR-APRN-LIC-158541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily