Provider Demographics
NPI:1043095391
Name:KLINE, MICHELLE CHERIE (FNP-C)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CHERIE
Last Name:KLINE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 2ND AVE N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MT
Mailing Address - Zip Code:59019-7186
Mailing Address - Country:US
Mailing Address - Phone:406-780-0396
Mailing Address - Fax:
Practice Address - Street 1:5 E 2ND AVE N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MT
Practice Address - Zip Code:59019-7186
Practice Address - Country:US
Practice Address - Phone:406-780-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT213555363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner