Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | NUR-APRN-LIC-177089 | MT |
NPI | 1033643713 |
---|---|
Provider Name | Asta Reindl |
First Address | Livingston, MT 59047-2444 |
Second Address | Bozeman, MT 59715-7248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2017 |
Last Update Date | 17/08/2021 |