MEDICARE: KELLI GIBBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant
2	363A00000X	Physician Assistant	MED-PAC-LIC-573	MT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M011004293	OTHER	MT	MEDICARE PTAN -

General Provider Information

NPI Number	:	1225279227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI GIBBS

Provider Business Mailing Address
First Line	:	PO BOX 31001
Second Line	:	4114
City	:	PASADENA
State	:	CA
Zip	:	91110-4114
Country	:	US
Telephone Number	:	406-329-5736
Fax Number	:	406-329-2941

Provider Business Practice Location Address
First Line	:	902 N ORANGE ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-2928
Country	:	US
Telephone Number	:	406-329-5736
Fax Number	:	406-329-2941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	01/30/2026

Similar Medicare Providers

1801835491 — DR. LAURA ANN SALYERS MD
Practice Location Address:

902 N. ORANGE ST. 2ND FLOOR , PROVIDENCE PSYCHIATRY
MISSOULA, MT
59802-2928

Practice Phone: 406-327-3362
Practice Fax: 406-327-3349

1003821976 — MR. BROOKS WILLIAM BAER LCPC
Practice Location Address:

902 N ORANGE ST , SUITE 102
MISSOULA, MT
59802-2928

Practice Phone: 406-327-3034
Practice Fax: 406-327-3385

1144319138 — PROVIDENCE HEALTH & SERVICES MT
Practice Location Address:

900 N ORANGE ST
MISSOULA, MT
59802-2928

Practice Phone: 406-329-5790
Practice Fax: 406-329-5877

1619058302 — PROVIDENCE HEALTH & SERVICES MT
Practice Location Address:

902 N ORANGE ST
MISSOULA, MT
59802-2928

Practice Phone: 406-542-7271
Practice Fax: 406-329-5877

1093830515 — ROBERT C. MUNJAL MD
Practice Location Address:

902 N ORANGE ST , SUITE 206
MISSOULA, MT
59802-2928

Practice Phone: 406-327-3362
Practice Fax:

1376704924 — MRS. FRANCESCA F AYTES LCSW
Practice Location Address:

902 N ORANGE ST STE 102
MISSOULA, MT
59802-2928

Practice Phone: 406-327-3034
Practice Fax: 406-327-3385

1336380161 — PROVIDENCE HEALTH & SERVICES MT
Practice Location Address:

902 N ORANGE ST
MISSOULA, MT
59802-2928

Practice Phone: 406-321-1732
Practice Fax: 425-687-3615

Directions to “ KELLI GIBBS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.