Provider Demographics
NPI:1477816791
Name:JENSEN, STORMY L (NP)
Entity Type:Individual
Prefix:
First Name:STORMY
Middle Name:L
Last Name:JENSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STORMY
Other - Middle Name:L
Other - Last Name:SHUMWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 35100
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-5100
Mailing Address - Country:US
Mailing Address - Phone:406-233-7000
Mailing Address - Fax:
Practice Address - Street 1:620 S HAYNES AVE
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-4769
Practice Address - Country:US
Practice Address - Phone:406-233-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT29481363L00000X
MTNUR-APRN-LIC-100570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner