Provider Demographics
NPI:1275543498
Name:HILLER, JANET (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:HILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16900
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808
Mailing Address - Country:US
Mailing Address - Phone:406-327-4620
Mailing Address - Fax:406-549-5928
Practice Address - Street 1:2827 FORT MISSOULA RD
Practice Address - Street 2:ROCKY MOUNTAIN NEONATOLOGY
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804
Practice Address - Country:US
Practice Address - Phone:406-327-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7881MT364SN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0073515Medicaid
G27057Medicare UPIN