Lead Provider: Sarah Cruse, MSN, APRN, FNP-BC, a-BHRT
Sarah Cruse is a board-certified Family Nurse Practitioner and the founder of 406 Health Consulting in Billings, Montana. With full practice authority under Montana law, she operates an independent, hybrid-model practice that blends conventional family medicine with advanced integrative wellness—delivering concierge-level care tailored to rural and underserved communities across the state.
A graduate of the University of Mary (FNP program, 2012), Sarah brings more than 15 years of clinical experience spanning emergency medicine, acute care, family practice, and outpatient settings. Her early career in high-acuity environments— including critical care and emergency department work—equipped her with the rapid-assessment skills and resilience that now inform her preventive, patient-centered approach. She previously practiced at Billings Clinic, DPHHS Crow Agency Emergency Department, and other Montana facilities where she honed her ability to manage complex cases under pressure.
Advanced Specialization in Bio-identical Hormone Optimization
What truly distinguishes Sarah from many of her colleagues in the hormone therapy and wellness space is her rare combination of emergency-level clinical rigor with cutting-edge, evidence-based optimization medicine. She is a certified Advanced Bio-identical Hormone Replacement Therapy (a-BHRT) provider through WorldLink Medical, one of the most respected training organizations in the field. Her WorldLink profile highlights her unique background: “Over 15 yrs of emergency provider experience incorporating Quality of Life cares via BHRT.”
She is also an active member of the Academy of Preventive and Innovative Medicine and holds advanced certifications in bio-identical hormone optimization and aesthetic procedures. This allows her to offer comprehensive, individualized programs in hormone balancing, weight management, regenerative therapies, and medical aesthetics—services that many traditional providers either avoid or approach with less depth.
A Hybrid, Patient-First Model in Rural Montana
Unlike many hormone specialists who operate purely cash-pay or stay within conventional insurance-only models, Sarah designed 406 Health Consulting as a true hybrid practice. She bills insurance for standard family medicine, preventive care, and medically necessary services while offering transparent cash-pay options for advanced wellness therapies. This model removes barriers for patients who need both routine care and life-changing optimization—particularly in Montana’s vast rural landscape, where access to specialized care is often limited.
Her philosophy centers on treating the whole person “across the lifespan during times of complex vulnerability.” Whether supporting a patient through perimenopause, optimizing vitality for high-performers, or providing acute care in a telemedicine setting, Sarah brings the same commitment to excellence that defined her emergency medicine roots.
What Sets Sarah Apart
Depth of Experience: Few hormone optimization providers carry her level of acute and emergency medicine training. This translates to safer, more nuanced care—especially when managing complex hormone cases alongside comorbidities.
Independence & Ownership: As a full-practice-authority NP who owns her clinic outright, she controls protocols, pricing, and patient experience without corporate constraints—something still uncommon even in progressive states like Montana.
Rural Focus with Urban-Level Expertise: She deliberately serves Montana’s rural communities, combining concierge innovation with the practicality required in areas where the nearest specialist may be hours away.
Evidence-Based + Innovative: Her WorldLink Medical certification and ongoing training in preventive medicine keep her at the forefront of BHRT science, while her aesthetic credentials allow seamless integration of regenerative and cosmetic services.
Patients and peers describe Sarah as a provider who listens deeply, explains clearly, and delivers results that restore not just hormones, but quality of life. In a field often criticized for hype or one-size-fits-all approaches, she stands out as the rare clinician who pairs rigorous medical training with genuine passion for helping people thrive.