At 406 Health Consulting, we provide compassionate, evidence-based healthcare tailored to your unique needs. Led by Sarah Cruse, APRN, FNP-BC — a board-certified Family Nurse Practitioner with full practice authority under Montana law — our practice combines conventional family medicine with advanced wellness services to support your health across the lifespan.

This is a self-pay practice. We do not accept or bill any medical insurance plans.

Our goal is to empower you with individualized plans that promote vitality, balance, and long-term well-being in a supportive, concierge-style environment — especially meaningful for patients in rural Montana communities.

• Experienced Provider: Sarah brings over 15 years of clinical expertise, including emergency and acute care, combined with advanced certifications in bio-identical hormone replacement therapy (through WorldLink Medical) and aesthetic procedures.

• Patient-Centered Approach: We listen deeply, explain options clearly, and develop plans based on your goals, lifestyle, and health history.

• Convenient Access: In-person visits in Billings and telemedicine options for follow-up care.

• Transparent Pricing: Pricing lists and estimates provided before your appointment.

• Family medicine and preventive care

• Bio-identical hormone optimization for men and women

• Weight management and metabolic health programs

• Medical aesthetics (e.g., injectables, skin rejuvenation)

• Integrative wellness consultations

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What is Integrative? Check this link out: https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name

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Services are provided by a licensed Advanced Practice Registered Nurse (APRN) in accordance with Montana Board of Nursing regulations.

• Results from hormone therapy, weight management, or aesthetic treatments vary by individual and depend on factors such as health status, adherence to recommendations, and lifestyle. No specific outcomes are guaranteed.

• Certain therapies (e.g., bio-identical hormones and some aesthetic procedures) may be considered off-label or not evaluated by the FDA for all uses. We base recommendations on clinical evidence, professional guidelines, and your personalized needs.

• This website is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for personalized recommendations.

• We comply with federal and state advertising guidelines (including FTC standards for health claims) and do not make unsubstantiated guarantees regarding results.

We are committed to providing secure, convenient, and compliant ways for our patients to stay connected with their care team.

• Our practice uses Tebra as our comprehensive electronic health record (EHR) system. Tebra is a HIPAA-compliant platform that securely manages patient records, scheduling, billing, and other essential functions to support high-quality care while protecting your privacy.

• For HIPAA-compliant patient communication, we utilize the Spruce platform. Spruce enables secure, encrypted messaging (including text, voice notes, and file sharing) designed specifically for healthcare.

Current patients have 24/7 access to messaging capabilities through the Spruce platform. You can send non-urgent concerns, questions about your care plan, follow-up requests, or general updates to your provider or care team at any time. Messages are reviewed during regular business hours (or sooner for time-sensitive matters as appropriate), and responses are provided as promptly as possible.

This secure messaging feature helps reduce the need for phone calls during busy clinic hours and allows for more flexible, ongoing communication—while always maintaining full HIPAA compliance and privacy protections.