Individual
CAILYN GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LN
Contact information
Practice address
19750 MT HIGHWAY 91 N, GLEN, MT 59732-8507
(406) 868-8915
Mailing address
PO BOX 922, BOZEMAN, MT 59771-0922
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
MED-NUTR-LIC-79498
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336
STATE OF WYOMING DIETETICS LICENSING BOARD
WY
01
—
86130394
COMMISSION ON DIETETIC REGISTRATION
—
01
—
MED-NUTR-LIC-79498
STATE OF MONTANA BOARD OF MEDICAL EXAMINERS
MT
Enumeration date
03/11/2020
Last updated
03/18/2024
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