Individual
STACI NOEL ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
147 HAWTHORNE CT UNIT B, WHITEFISH, MT 59937-7975
(405) 831-2195
Mailing address
147 HAWTHORNE CT UNIT B, WHITEFISH, MT 59937-7975
(405) 831-2195
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-11407
AR
207LP3000X
Pediatric Anesthesiology Physician
E11407
AR
207LP3000X
Pediatric Anesthesiology Physician
MED-PHYS-LIC-128975
MT
Other
Enumeration date
06/12/2013
Last updated
10/06/2023
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