Healthcare Provider Details

I. General information

NPI: 1407725021
Provider Name (Legal Business Name): BRANDIE NICOLE STAPLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 10TH AVE N
BILLINGS MT
59101-0703
US

IV. Provider business mailing address

5317 PRYOR MOUNTAIN VIEW DR
BILLINGS MT
59101-7244
US

V. Phone/Fax

Practice location:
  • Phone: 307-690-0574
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNUR-APRN-LIC-286901
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberNUR-APRN-LIC-286901
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number75207
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: