Individual
REBECCA NICOLE STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
301 KNAPP ST, WOLF POINT, MT 59201-1826
(406) 653-2150
Mailing address
301 KNAPP ST, WOLF POINT, MT 59201-1826
(406) 653-2150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1610
SD
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-70041
MT
Other
Enumeration date
11/13/2018
Last updated
09/16/2025
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