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General NPI Number Information
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NPI Number | 1750990560
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Entity Type | Individual
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Provider Name | NICOLE RAY BILLMAN PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 3425 13TH ST
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City | BAKER CITY
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State | OR
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Zip | 97814-1340
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Country | US
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Telephone | 541-534-7400
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Fax | 541-523-4927
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Provider Business Mailing Address
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Address Line | 3425 13TH ST
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City | BAKER CITY
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State | OR
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Zip | 97814-1340
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Country | US
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Telephone | 541-534-7400
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Fax | 541-523-4927
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10029026
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 201705800RN
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 201705800R
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License Number State | OR
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