Provider Demographics
NPI:1306905385
Name:BABB, DEANNA L (APRN, DNP)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:L
Last Name:BABB
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2510
Mailing Address - Country:US
Mailing Address - Phone:406-727-5778
Mailing Address - Fax:406-761-4346
Practice Address - Street 1:601 1ST AVE N
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-2510
Practice Address - Country:US
Practice Address - Phone:406-727-5778
Practice Address - Fax:406-761-4346
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN13265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4305405Medicaid
MTP62654Medicare UPIN