Provider Demographics
NPI:1043337140
Name:APPLEGATE, HEIDE LYNN (FNP)
Entity type:Individual
Prefix:
First Name:HEIDE
Middle Name:LYNN
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59722-1000
Mailing Address - Country:US
Mailing Address - Phone:406-846-4275
Mailing Address - Fax:
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:DEER LODGE
Practice Address - State:MT
Practice Address - Zip Code:59722-1000
Practice Address - Country:US
Practice Address - Phone:406-846-4275
Practice Address - Fax:406-846-4278
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1000357363LF0000X
MT25000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily