Provider Demographics
NPI:1780374983
Name:GUNTER, KALEN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KALEN
Middle Name:MARIE
Last Name:GUNTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:ALDER
Mailing Address - State:MT
Mailing Address - Zip Code:59710-0208
Mailing Address - Country:US
Mailing Address - Phone:435-820-2007
Mailing Address - Fax:
Practice Address - Street 1:1307 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4801
Practice Address - Country:US
Practice Address - Phone:406-479-5092
Practice Address - Fax:406-479-5093
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA-2747363AM0700X
MTMED-PAC-LIC-136407363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical