Provider Demographics
NPI:1740711167
Name:BIRKELAND, VICTORIA ANN (FNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANN
Last Name:BIRKELAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1317
Mailing Address - Street 2:
Mailing Address - City:FORT BENTON
Mailing Address - State:MT
Mailing Address - Zip Code:59442
Mailing Address - Country:US
Mailing Address - Phone:406-868-9380
Mailing Address - Fax:
Practice Address - Street 1:4221 NORTH BENCH ROAD
Practice Address - Street 2:
Practice Address - City:FORT BENTON
Practice Address - State:MT
Practice Address - Zip Code:59442-1317
Practice Address - Country:US
Practice Address - Phone:406-868-9380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT125023363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily