Provider Demographics
NPI:1538478581
Name:DELANEY, KATIE MIKEL (RD, LN)
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:MIKEL
Last Name:DELANEY
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:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:GRASS RANGE
Mailing Address - State:MT
Mailing Address - Zip Code:59032-0095
Mailing Address - Country:US
Mailing Address - Phone:406-366-1986
Mailing Address - Fax:
Practice Address - Street 1:3303 DELANEY ROAD
Practice Address - Street 2:
Practice Address - City:GRASS RANGE
Practice Address - State:MT
Practice Address - Zip Code:59032
Practice Address - Country:US
Practice Address - Phone:406-366-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT578133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT578OtherMT LICENSE NUMBER