Provider Demographics
NPI:1124183108
Name:BILLINGS, JOHN VERN (ARNP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:VERN
Last Name:BILLINGS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6734 N SUTHERLIN ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5048
Mailing Address - Country:US
Mailing Address - Phone:509-456-5733
Mailing Address - Fax:509-327-5191
Practice Address - Street 1:5901 N LIDGERWOOD ST
Practice Address - Street 2:SUITE 215
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5095
Practice Address - Country:US
Practice Address - Phone:509-456-5733
Practice Address - Fax:509-327-5191
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004240163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9620501Medicaid
WAS45353Medicare UPIN
WAGAB29363Medicare ID - Type Unspecified