Provider Demographics
NPI:1548934359
Name:SELL, CARLY R (PMHNP)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:R
Last Name:SELL
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BUGLE CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59647-8512
Mailing Address - Country:US
Mailing Address - Phone:406-459-9227
Mailing Address - Fax:
Practice Address - Street 1:1111 N RODNEY ST STE 4E
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3514
Practice Address - Country:US
Practice Address - Phone:406-459-9227
Practice Address - Fax:406-634-3302
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2023-11-08
Deactivation Date:2022-10-03
Deactivation Code:
Reactivation Date:2022-10-11
Provider Licenses
StateLicense IDTaxonomies
MT196374363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health