Healthcare Provider Details

I. General information

NPI: 1891616702
Provider Name (Legal Business Name): GRACE LLOYD PICKETT PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 VILLAGE LN
BILLINGS MT
59102-2491
US

IV. Provider business mailing address

1609 S BLACK AVE
BOZEMAN MT
59715-5701
US

V. Phone/Fax

Practice location:
  • Phone: 406-657-1000
  • Fax:
Mailing address:
  • Phone: 720-548-7525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: