Healthcare Provider Details

I. General information

NPI: 1235848714
Provider Name (Legal Business Name): NICOLE KILIAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 5TH AVE S
GREAT FALLS MT
59405-3337
US

IV. Provider business mailing address

244 SUN LOOP LN
GREAT FALLS MT
59404-6232
US

V. Phone/Fax

Practice location:
  • Phone: 406-315-3503
  • Fax: 406-315-3505
Mailing address:
  • Phone: 503-998-0679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-198476
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number198476
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: