Individual provider Active NPI

Kiely M Howard, MS, APRN-PMHCNS, BC

  • Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
  • Missoula, MT
National Provider Identifier
1336248046
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X
License
28149 Issued in MT
Practice address
500 N Higgins Ave Ste 200
Missoula, MT 59802-4550
Phone
(406) 721-3977
Fax
(406) 721-3991
NPI assigned
Sep 21, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 28149 MT Primary

Addresses

Primary practice location

500 N Higgins Ave Ste 200
Missoula, MT 59802-4550

Mailing address

PO Box 8525
Missoula, MT 59807-8525
Phone (406) 721-3977

Other identifiers 2

IdentifierTypeStateIssuer
374830OtherMTBCBS
4306224MedicaidMT

Other names 1

  • Kiely M Crocker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
28149MTMDChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1336248046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8525",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598078525",
            "telephone_number": "406-721-3977",
            "fax_number": "406-721-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N HIGGINS AVE STE 200",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024550",
            "telephone_number": "406-721-3977",
            "fax_number": "406-721-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "KIELY",
        "middle_name": "M",
        "credential": "MS, APRN-PMHCNS, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MT",
            "license": "28149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "374830",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4306224",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIELY",
            "last_name": "CROCKER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.