Individual
DEANNA LEE NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
123 S 27TH ST, BILLINGS, MT 59101-4227
(406) 967-2255
(405) 967-2251
Mailing address
123 S 27TH ST, BILLINGS, MT 59101-4227
(406) 967-2255
(405) 967-2251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
643MT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
332WY
WY MEDICAL LICENSE #
WY
01
—
MT 643
MT LICENSE
MT
Enumeration date
02/01/2006
Last updated
03/07/2023
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