Healthcare Provider Details

I. General information

NPI: 1528778594
Provider Name (Legal Business Name): DANIELLE L GRUBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 UNIVERSITY DR
BILLINGS MT
59101-0245
US

IV. Provider business mailing address

202 S MARYLAND ST
CONRAD MT
59425-2018
US

V. Phone/Fax

Practice location:
  • Phone: 406-944-3597
  • Fax:
Mailing address:
  • Phone: 406-590-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNUR-APRN-LIC-293414
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: