Healthcare Provider Details

I. General information

NPI: 1891361549
Provider Name (Legal Business Name): AMY OLIVER STETSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 HIGHLAND BLVD STE 5410
BOZEMAN MT
59715-6916
US

IV. Provider business mailing address

915 HIGHLAND BLVD
BOZEMAN MT
59715-6902
US

V. Phone/Fax

Practice location:
  • Phone: 406-414-5000
  • Fax:
Mailing address:
  • Phone: 406-414-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-171237
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: