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NPI Code Detail

MEDICARE: REBECCA MARIE LULL MD

MEDICARE: REBECCA MARIE LULL MD
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
1207Q00000XFamily Medicine PhysicianMED-PHYS-LIC-114608MT

General Provider Information

NPI Number : 1912560269
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA MARIE LULL MD
Provider Business Mailing Address
First Line : 310 SUNNYVIEW LN
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 160 HERITAGE WAY STE 202
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3127
Country : US
Telephone Number : 406-752-8433
Fax Number : 406-756-6768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2019
Last Update Date : 01/14/2026

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Directions to “ REBECCA MARIE LULL MD” Practice Location

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