Provider Demographics
NPI:1255826335
Name:LINER, NANCY (RD, LN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LINER
Suffix:
Gender:F
Credentials:RD, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 PATTEE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1621
Mailing Address - Country:US
Mailing Address - Phone:406-830-0883
Mailing Address - Fax:
Practice Address - Street 1:502 PATTEE CANYON DR
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1621
Practice Address - Country:US
Practice Address - Phone:406-830-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT27749133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered