Provider Demographics
NPI:1275056665
Name:GIESE, TAMARA MAE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:MAE
Last Name:GIESE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 CHANEL LOOP
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-8951
Mailing Address - Country:US
Mailing Address - Phone:605-845-8419
Mailing Address - Fax:
Practice Address - Street 1:3333 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6565
Practice Address - Country:US
Practice Address - Phone:406-652-1620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6508183500000X
MTPHA-PHA-LIC-46984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist