KA MOUA (NPI# 1780946764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780946764 |
| Entity Type | Individual |
| Full Name | KA MOUA |
| Credential | APRN |
| Practice Address |
2685 Palmer St Ste D Missoula MT 59808-1709 |
| Mailing Address |
Po Box 997 Lolo MT 59847-0997 |
| Practice Telephone | 8775221275 |
| Practice Fax Number | 4068298543 |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2020-09-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
30952 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1300 S Reserve St Ste H, Missoula, MT 598014704 | 4062035174 | 0000000000 |
| 2835 Fort Missoula Rd, Ste. 102, Missoula, MT 598047423 | 4065417246 | 4067218298 |
| 715 Kensington Ave Ste 1, Missoula, MT 598015700 | 4062035174 |
| Street Address |
2685 PALMER ST STE D |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134757198 | Ideal Balance Pllc | Community/Behavioral Health | 2685 Palmer St Ste D, Missoula, MT 59808-1709 | 2020-03-27 |
| 1598313801 | Ideal Option Pllc | Clinic/Center | 2685 Palmer St Ste D, Missoula, MT 59808-1709 | 2019-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
| 1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
| 1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
| 1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
| 1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
| 1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
| 1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
| 1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
| 1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
| 1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
| Find all providers in zip 59808 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730656299 | Brandi Roman Glibbery | Nurse Practitioner | 4109 Barbara Ln, Missoula, MT 59803-1114 | 2018-11-01 |
| 1326526948 | Ruth Elizabeth King | Nurse Practitioner | 6114 Helena Dr, Missoula, MT 59803-2706 | 2018-08-06 |
| 1205313590 | Michelle Weaver Knowles | Nurse Practitioner | 2825 Fort Missoula Rd Ste 113, Missoula, MT 59804-7403 | 2018-07-19 |
| 1467995928 | Sarah Slater | Nurse Practitioner | 1101 S 3rd St W Ste 101, Missoula, MT 59801-2321 | 2016-11-30 |
| 1992161772 | Jennifer Jane Lee Simon | Nurse Practitioner | 500 W Broadway St Ste 310, Missoula, MT 59802-4003 | 2016-01-08 |
| 1427489822 | Katrina Lin Brucker | Nurse Practitioner | 902 N Orange St Ste 202, Missoula, MT 59802-2928 | 2013-12-10 |
| 1659704526 | Heidi Efinger | Nurse Practitioner | 2340 Mullan Rd, Missoula, MT 59808-1830 | 2013-08-15 |
| 1427301589 | Adeline May Wakeman | Nurse Practitioner | 728 Monroe St, Apt. A, Missoula, MT 59802-3716 | 2012-10-25 |
| 1871843953 | Autum Emerson Howell | Nurse Practitioner | 2831 Ft. Missoula Rd. Bldg 2, 102, Missoula, MT 59804 | 2012-09-14 |
| 1083921233 | Sally Rebecca Baskett | Nurse Practitioner | 702 Sw Higgins Ave, Missoula, MT 59803-1429 | 2010-09-09 |
| Find all providers in MISSOULA | ||||
Please comment or provide details below to improve the information on KA MOUA.
| 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.