Provider Demographics
NPI:1649728577
Name:TOTAL FAMILY CARE PLLP
Entity type:Organization
Organization Name:TOTAL FAMILY CARE PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:DAWNE
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:850-459-2273
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-0419
Mailing Address - Country:US
Mailing Address - Phone:406-538-4067
Mailing Address - Fax:406-206-5837
Practice Address - Street 1:611 NE MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-4000
Practice Address - Country:US
Practice Address - Phone:406-538-4067
Practice Address - Fax:406-206-5837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAPRN 100952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty