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NPI Code Detail

MEDICARE: DIANE D. GOEDDE MSN

MEDICARE: DIANE D. GOEDDE MSN
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN20719MT
2363LP0808XPsychiatric/Mental Health Nurse PractitionerNUR-APRN-LIC-100408MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1119425900OTHERWYMDCD PIN
2000374040OTHERMTBCBS PIN

General Provider Information

NPI Number : 1922110998
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE D. GOEDDE MSN
Provider Business Mailing Address
First Line : PO BOX 35100
Second Line :
City : BILLINGS
State : MT
Zip : 59107-5100
Country : US
Telephone Number : 406-238-2500
Fax Number :
Provider Business Practice Location Address
First Line : 2950 10TH AVE N
Second Line :
City : BILLINGS
State : MT
Zip : 59101-0720
Country : US
Telephone Number : 406-238-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 12/14/2021

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