Provider Demographics
NPI:1346785052
Name:TSIRIGOTIS, STEFANI L (CRNP)
Entity Type:Individual
Prefix:
First Name:STEFANI
Middle Name:L
Last Name:TSIRIGOTIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:STEFANI
Other - Middle Name:
Other - Last Name:HAISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:332 PAUL BUNYAN LN
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-7997
Mailing Address - Country:US
Mailing Address - Phone:607-368-6928
Mailing Address - Fax:
Practice Address - Street 1:350 HERITAGE WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3158
Practice Address - Country:US
Practice Address - Phone:406-890-7432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016871363L00000X
MTNUR-APRN-LIC160976363LA2100X
MT160976363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner