Healthcare Provider Details

I. General information

NPI: 1164964672
Provider Name (Legal Business Name): DARLENE MARIE SANDERS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARLENE MARIE PELLETIER

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 N 29TH ST
BILLINGS MT
59101-0122
US

IV. Provider business mailing address

1231 N 29TH ST
BILLINGS MT
59101
US

V. Phone/Fax

Practice location:
  • Phone: 406-248-3175
  • Fax:
Mailing address:
  • Phone: 406-248-3175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMED-PAC-LIC 51937
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: