Provider Demographics
NPI:1982378238
Name:THRALLS, CLAIRE EILEEN (PMHNP)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:EILEEN
Last Name:THRALLS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:EILEEN
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1745 S 9TH ST W
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3432
Mailing Address - Country:US
Mailing Address - Phone:406-207-7442
Mailing Address - Fax:
Practice Address - Street 1:725 SW HIGGINS AVE STE D
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1420
Practice Address - Country:US
Practice Address - Phone:406-207-7442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-177218363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTNUR-APRN-LIC-177218OtherSTATE ISSUED LICENSE NUMBER