Healthcare Provider Details

I. General information

NPI: 1326363839
Provider Name (Legal Business Name): KESSA MAURAS DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 11TH AVE S STE 6
GREAT FALLS MT
59405-4654
US

IV. Provider business mailing address

PO BOX 6010
GREAT FALLS MT
59406-6010
US

V. Phone/Fax

Practice location:
  • Phone: 406-761-2222
  • Fax: 406-761-7219
Mailing address:
  • Phone: 406-455-5000
  • Fax: 406-731-8318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDP153769
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number175202
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number80239
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN006318
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: