1528244407 NPI number — DIANNE B BILLGER CNP

Table of content: DIANNE B BILLGER CNP (NPI 1528244407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528244407 NPI number — DIANNE B BILLGER CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BILLGER
Provider First Name:
DIANNE
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VANORMER
Provider Other First Name:
DIANNE
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1528244407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 N CAMPBELL AVE
Provider Second Line Business Mailing Address:
P.O. BOX 245028
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85724-6370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-626-9024
Provider Business Mailing Address Fax Number:
520-874-7133

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 N CAMPBELL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85724-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-626-9024
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  AP7647 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4992472 . This is a "BLUE CROSS/SOUTH DAKOTA" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 0573089 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 027168000 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102265 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6830040 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 76L87BI . This is a "CC SYSTEMS/BLUE PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9256981 . This is a "DAKOTACARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1528244407 . This is a "ARAZ/AMERICA'S PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 57105K013 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 76L87BI . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 557891053783 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1528244407 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".




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