Individual provider Active NPI

Diana Elizabeth Liedtka-Holmquist, DNP

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1912612169
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NUR-APRN-LIC-242748 Issued in MT
Practice address
2126 Dixon Ave
Missoula, MT 59801-8226
Phone
(406) 241-6069
NPI assigned
Jan 20, 2023
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NUR-APRN-LIC-242748 MT Primary

Addresses

Primary practice location

2126 Dixon Ave
Missoula, MT 59801-8226

Mailing address

2126 Dixon Ave
Missoula, MT 59801-8226
Phone (406) 241-6069

Other names 1

  • Mrs. Diana Elizabeth Liedtka-Holmquist Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-242748MTMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1912612169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 DIXON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018226",
            "telephone_number": "406-241-6069",
            "fax_number": "406-926-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 DIXON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018226",
            "telephone_number": "406-241-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDTKA-HOLMQUIST",
        "first_name": "DIANA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-20",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-242748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "LIEDTKA-HOLMQUIST",
            "middle_name": "ELIZABETH",
            "prefix": "MRS.",
            "credential": "DNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.