Individual
JESSICA LYNN PEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1331 24TH ST W, BILLINGS, MT 59102-3860
(406) 656-5846
Mailing address
1331 24TH ST W, BILLINGS, MT 59102-3860
(406) 794-7656
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2887AT
OR
152W00000X
Optometrist
Primary
787
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011002681
BILLING PTAN
MT
01
—
011002682
RENDERING PTAN
MT
05
—
1417060104
—
MT
01
—
1801037916
MEDICARE BILLING PROVIDER NPI
MT
Enumeration date
08/16/2006
Last updated
05/19/2010
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