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NPI Code Detail

MEDICARE: DR. VICKI NIEMANTS BURFORD

MEDICARE: DR. VICKI NIEMANTS BURFORD
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
11041C0700XClinical Social Worker77MT

General Provider Information

NPI Number : 1477764512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VICKI NIEMANTS BURFORD
Provider Business Mailing Address
First Line : 2740 GREGORY DR S
Second Line :
City : BILLINGS
State : MT
Zip : 59102-0510
Country : US
Telephone Number : 406-656-6658
Fax Number :
Provider Business Practice Location Address
First Line : 902 WYOMING AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59101-1637
Country : US
Telephone Number : 406-252-6082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 07/08/2007

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