Basic Information
| Provider Information | |||||||||
| NPI: | 1528244407 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BILLGER | ||||||||
| FirstName: | DIANNE | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VANORMER | ||||||||
| OtherFirstName: | DIANNE | ||||||||
| OtherMiddleName: | B | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1501 N CAMPBELL AVE | ||||||||
| Address2: | P.O. BOX 245028 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857246370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206269024 | ||||||||
| FaxNumber: | 5208747133 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 N CAMPBELL AVE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857240001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206269024 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2008 | ||||||||
| LastUpdateDate: | 06/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | AP7647 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 4992472 | 01 | SD | BLUE CROSS/SOUTH DAKOTA | OTHER | 0573089 | 05 | IA | MEDICAID | 027168000 | 05 | MN | MEDICAID | 102265 | 01 | RR MEDICARE | OTHER | 6830040 | 05 | SD | MEDICAID | 76L87BI | 01 | CC SYSTEMS/BLUE PLUS | OTHER | 9256981 | 01 | DAKOTACARE | OTHER | 1528244407 | 01 | ARAZ/AMERICA'S PPO | OTHER | 57105K013 | 01 | TRICARE | OTHER | 76L87BI | 01 | MN | BLUE CROSS | OTHER | 557891053783 | 01 | PREFERRED ONE | OTHER | 1528244407 | 01 | MEDICA | OTHER |