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NPI Code Detail

MEDICARE: NICHOLAS KELLNER

MEDICARE:   NICHOLAS  KELLNER
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
1133V00000XRegistered Dietitian
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1639034010
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS KELLNER
Provider Business Mailing Address
First Line : 1511 POLY DR
Second Line :
City : BILLINGS
State : MT
Zip : 59102-1739
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1511 POLY DR
Second Line :
City : BILLINGS
State : MT
Zip : 59102-1739
Country : US
Telephone Number : 406-657-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2025
Last Update Date : 12/18/2025

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Directions to “ NICHOLAS KELLNER ” Practice Location

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