Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 9821 | MT |
N | 111NI0900X | Internist | 9821 | MT |
Y | 207RG0300X | Geriatric Medicine | 9821 | MT |
NPI | 1073535019 |
---|---|
Provider Name | Dr. Kathryn Borgenicht |
First Address | Bozeman, MT 59715-6902 |
Second Address | Bozeman, MT 59715-6903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 15/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000098471 | BLUE CROSS MT (01) | MT |
0091409 | (05) | MT |
A47862 | (02) | |
P00205974 | MEDICARE RAILROAD (01) |