Individual
DR. KRISTA NIEZWAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, DO
Contact information
Practice address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 414-5000
Mailing address
1625 N CAMPBELL AVE, TUCSON, AZ 85719-4330
(520) 694-0111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MED-PHYS-LIC-159836
MT
207P00000X
Emergency Medicine Physician
R3766
AZ
207R00000X
Internal Medicine Physician
MED-PHYS-LIC-159836
MT
363A00000X
Physician Assistant
085005134
IL
Other
Enumeration date
09/02/2014
Last updated
02/25/2026
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