Provider Demographics
NPI:1427314632
Name:DEVER, STEPHANIE G (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:G
Last Name:DEVER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:G
Other - Last Name:DEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:300 GARNET WAY
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59756-9700
Mailing Address - Country:US
Mailing Address - Phone:406-693-7000
Mailing Address - Fax:
Practice Address - Street 1:300 GARNET WAY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:MT
Practice Address - Zip Code:59756-9700
Practice Address - Country:US
Practice Address - Phone:406-693-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT146565363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health