Provider Demographics
NPI:1477546760
Name:RIFFE, STACEY L (CPNP-PC, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:L
Last Name:RIFFE
Suffix:
Gender:F
Credentials:CPNP-PC, FNP-C
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:L
Other - Last Name:RIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-PC, FNP-C
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834-0535
Mailing Address - Country:US
Mailing Address - Phone:406-541-4700
Mailing Address - Fax:406-541-4701
Practice Address - Street 1:16862 BECKWITH ST.
Practice Address - Street 2:SUITE Q
Practice Address - City:FRENCHTOWN
Practice Address - State:MT
Practice Address - Zip Code:59834
Practice Address - Country:US
Practice Address - Phone:406-327-4046
Practice Address - Fax:406-327-4071
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN29524363L00000X
MT100571363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
374800OtherBC MT