Provider Demographics
NPI:1104012947
Name:QUICK, DIANE M (APRN)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:QUICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 GRAND AVE., SUITE 6
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6258
Mailing Address - Country:US
Mailing Address - Phone:406-839-2985
Mailing Address - Fax:406-839-2986
Practice Address - Street 1:3737 GRAND AVE., SUITE 6
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6258
Practice Address - Country:US
Practice Address - Phone:406-839-2985
Practice Address - Fax:406-839-2986
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-100384363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTVENDOR #0216125Medicaid
MTVENDOR #0216125Medicaid