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General NPI Number Information
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NPI Number | 1104862416
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Entity Type | Individual
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Provider Name | DEBRA L MIKUS M.S.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 299 FAIRGROUNDS RD UNIT 4
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City | HAMILTON
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State | MT
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Zip | 59840-3199
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Country | US
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Telephone | 406-549-1951
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Fax | 406-542-5682
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Provider Business Mailing Address
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Address Line | 317 S ORANGE ST
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City | MISSOULA
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State | MT
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Zip | 59801-1810
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Country | US
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Telephone | 406-549-1951
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Fax | 406-542-5682
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 13817
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 13817
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License Number State | MT
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