Healthcare Provider Details

I. General information

NPI: 1962403840
Provider Name (Legal Business Name): DEBBIE K BJORSNESS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 26TH ST S
GREAT FALLS MT
59405-5161
US

IV. Provider business mailing address

1404 34TH ST S
GREAT FALLS MT
59405-5434
US

V. Phone/Fax

Practice location:
  • Phone: 406-455-5526
  • Fax: 406-455-4965
Mailing address:
  • Phone: 406-727-4284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number116
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: