| Montana Stillwater Health, Pllc | |
|
2875 Tina Ave Ste 102ab Missoula MT 59808-1581 | |
| (406) 272-3746 | |
| (406) 303-3308 |
| Full Name | Montana Stillwater Health, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2875 Tina Ave Ste 102ab, Missoula, Montana |
| Authorized Official Name and Position | Jennifer Kaye Shepard (OWNER) |
| Authorized Official Contact | 4062723746 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montana Stillwater Health, Pllc Po Box 17521 Missoula MT 59808-7521 Ph: () - | Montana Stillwater Health, Pllc 2875 Tina Ave Ste 102ab Missoula MT 59808-1581 Ph: (406) 272-3746 |
| NPI Number | 1144942830 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 02/05/2023 |
| Medicare PECOS PAC ID | 5092182808 |
|---|---|
| Medicare Enrollment ID | O20221108002862 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144942830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Shepard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417342601 PECOS PAC ID: 5294015731 Enrollment ID: I20201117001762 |
| Provider Name | Whitney Haseman |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1255726469 PECOS PAC ID: 9133409659 Enrollment ID: I20201117001997 |
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