Provider Demographics
NPI:1750372637
Name:HEBERLING, KAREN D (FNP, NP-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:HEBERLING
Suffix:
Gender:F
Credentials:FNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 WINDWARD WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3133
Mailing Address - Country:US
Mailing Address - Phone:406-756-8488
Mailing Address - Fax:406-257-4663
Practice Address - Street 1:245 WINDWARD WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3133
Practice Address - Country:US
Practice Address - Phone:406-756-8488
Practice Address - Fax:406-257-4663
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-33760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT011002775OtherMEDICARE PTAN
MT1750372637Medicaid
MT1750372637Medicaid
ID13-1822Medicare Oscar/Certification