Individual
DR. MAKENNA ANN STAVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 W BROADWAY ST FL 4, MISSOULA, MT 59802-4008
(406) 327-1900
Mailing address
500 W BROADWAY ST FL 4, MISSOULA, MT 59802-4008
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MED-PHYS-LIC-148232
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2022
Last updated
07/06/2025
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