Individual
SUSAN NILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
931 HIGHLAND BLVD, BOZEMAN, MT 59715-6911
(406) 414-5000
Mailing address
931 HIGHLAND BLVD, BOZEMAN, MT 59715-6911
(406) 414-5000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
29203
MT
Other
Enumeration date
01/13/2015
Last updated
12/04/2015
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