Healthcare Provider Details

I. General information

NPI: 1164012761
Provider Name (Legal Business Name): STEPHEN WURZ DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ANNA PEARL SHERRICK HALL
BOZEMAN MT
59717
US

IV. Provider business mailing address

3101 2ND AVE S
GREAT FALLS MT
59405-3351
US

V. Phone/Fax

Practice location:
  • Phone: 406-994-3783
  • Fax:
Mailing address:
  • Phone: 406-994-3429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-250962
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: