Provider Demographics
NPI:1962134536
Name:STEBEN, JENNY (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:STEBEN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 ROAD 106
Mailing Address - Street 2:
Mailing Address - City:WIBAUX
Mailing Address - State:MT
Mailing Address - Zip Code:59353-9056
Mailing Address - Country:US
Mailing Address - Phone:515-402-8283
Mailing Address - Fax:
Practice Address - Street 1:202 PROSPECT DR
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330-1999
Practice Address - Country:US
Practice Address - Phone:406-345-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG168307363LP0808X
MTNUR-APRN-LIC-215674363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health