KEITH FORKIN (NPI# 1093252546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093252546 |
| Entity Type | Individual |
| Full Name | KEITH FORKIN |
| Practice Address |
301 S 5th St E Apt 3d Missoula MT 59801-2751 |
| Mailing Address |
301 S 5th St E Apt 3d Missoula MT 59801-2755 |
| Practice Telephone | 4064387669 |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | MT | Student, Health Care |
| Street Address |
301 S 5TH ST E APT 3D |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-2751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457916389 | Courtney Czorny | Student in an Organized Health Care Education/Training Program | 6550 Justin Ct, Missoula, MT 59803-2968 | 2019-05-06 |
| 1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
| 1083151138 | Madison Mccarthy | Student in an Organized Health Care Education/Training Program | 2470 Peregrine Loop, Missoula, MT 59808-5812 | 2017-01-27 |
| 1063959328 | Stephanie Swindell | Student in an Organized Health Care Education/Training Program | 4000 Mullan Rd Apt F328, Missoula, MT 59808-5149 | 2017-01-25 |
| 1659520138 | Robert B Curry | Student in an Organized Health Care Education/Training Program | 634 Eddy St, Missoula, MT 59812 | 2008-09-09 |
| 1922612431 | Jaala M Wickman | Student in an Organized Health Care Education/Training Program | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-09-02 |
| 1205453552 | Tedijo Todd | Student in an Organized Health Care Education/Training Program | 6114 Helena Dr, Missoula, MT 59803-2706 | 2020-07-02 |
| 1255950143 | Barbara Janelle Steward | Student in an Organized Health Care Education/Training Program | 401 Railroad St W, Missoula, MT 59802-4109 | 2020-04-10 |
| 1134748114 | Benjamin Ray Merbler | Student in an Organized Health Care Education/Training Program | 401 Railroad St W, Missoula, MT 59802-4109 | 2020-04-10 |
| 1316576960 | Rachael Schmidt | Student in an Organized Health Care Education/Training Program | 401 Railroad St W, Missoula, MT 59802-4109 | 2020-04-06 |
| Find all providers in MISSOULA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.