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General NPI Number Information
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NPI Number | 1811189871
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Entity Type | Individual
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Provider Name | JESSICA RAE STERN MD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 20 3RD ST E AWARE, INC
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City | KALISPELL
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State | MT
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Zip | 59901-4573
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Country | US
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Telephone | 406-890-8725
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Fax |
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Provider Business Mailing Address
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Address Line | 20 3RD ST E AWARE, INC
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City | KALISPELL
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State | MT
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Zip | 59901-4573
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Country | US
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Telephone | 406-890-8725
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18315
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 18315
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License Number State | MT
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