Provider Demographics
NPI:1235563669
Name:ANGERT, STEPHANIE D (ARNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:D
Last Name:ANGERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0012
Mailing Address - Country:US
Mailing Address - Phone:406-327-1918
Mailing Address - Fax:406-329-2937
Practice Address - Street 1:5549 OLD HIGHWAY 93
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MT
Practice Address - Zip Code:59833-6845
Practice Address - Country:US
Practice Address - Phone:406-279-4923
Practice Address - Fax:406-329-4174
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT37234364SF0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health