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General NPI Number Information
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NPI Number | 1023832235
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Entity Type | Individual
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Provider Name | KEISHA MARIE STOSICH RN
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Gender | Female
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 25 W FRONT ST
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City | BUTTE
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State | MT
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Zip | 59701-2801
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Country | US
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Telephone | 406-497-5075
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Fax | 406-497-5095
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Provider Business Mailing Address
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Address Line | 25 W FRONT ST
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City | BUTTE
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State | MT
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Zip | 59701-2801
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Country | US
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Telephone | 406-497-5075
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Fax | 406-497-5095
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | NUR-RN-LIC-39649
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | NUR-RN-LIC-39649
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | NUR-RN-LIC-39649
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License Number State | MT
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