Provider Demographics
NPI:1962403840
Name:BJORSNESS, DEBBIE K (RD)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:K
Last Name:BJORSNESS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 34TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5434
Mailing Address - Country:US
Mailing Address - Phone:406-727-4284
Mailing Address - Fax:
Practice Address - Street 1:1101 26TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5161
Practice Address - Country:US
Practice Address - Phone:406-455-5526
Practice Address - Fax:406-455-4965
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT116133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0003616Medicaid
MT000003616Medicare ID - Type Unspecified