STACEY RENEE VIERRA (NPI# 1952541716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952541716 |
| Entity Type | Individual |
| Full Name | STACEY RENEE VIERRA |
| Credential | PA-C |
| Practice Address |
7300 North Perimeter Road 341 Medical Group Malmstrom Afb MT 59402 |
| Practice Telephone | 4067314368 |
| Practice Fax Number | 4067312691 |
| Mailing Telephone | 4067314368 |
| Mailing Fax Number | 4067312691 |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2015-09-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7300 NORTH PERIMETER ROAD 341 MEDICAL GROUP |
| City | MALMSTROM AFB |
| State | MT |
| Zip Code | 59402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700807112 | Scott Michael Sonnek | Psychologist | 7300 North Perimeter Road, Malmstrom Afb, MT 59402-6780 | 2006-07-21 |
| 1073842977 | Robert Alexander | Physician Assistant | 7300 North Perimeter Road, 341 Medical Group/sghq, Malmstrom Afb, MT 59402-6780 | 2009-12-24 |
| 1306094461 | Jeremy Gustafson | Pharmacist | 7300 North Perimeter Road, Malmstrom Afb, MT 59402 | 2008-09-03 |
| 1346322500 | Jeremy Allen Jensen | Psychiatry & Neurology | 7300 North Perimeter Road, 341 Medical Group, Malmstrom Afb, MT 59402-6780 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255166 | Jonathan Tankersley | Dentist | 7300 Perimeter Rd, Malmstrom Afb, Mt 59402, Dental Clinic, Apo, AA 59402 | 2017-06-13 |
| 1780061960 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 7200 Perimeter Rd., Bldg 1340, Malmstrom Afb, MT 59402 | 2015-04-27 |
| 1396181533 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 341 Mdg/mdss/sgsa 7300 N Perimeter Rd, Bldg 2040, Malstrom Afb, MT 59402 | 2013-05-15 |
| 1205098258 | Dennis Gordon Vanhook | Social Worker | 7300 N Peirmeter Road, 341st Medical Group, Malmstrom Afb, MT 59402 | 2008-07-01 |
| 1437205119 | Misty Dawn Robertson | Dental Hygienist | 3700 N Perimeter Road, Malmstrom Afb, MT 59402 | 2007-01-26 |
| 1699738278 | Carol F Nelson | Nurse Practitioner | 7300 North Perimeter Rd, Malmstrom Afb, MT 59402 | 2006-04-06 |
| 1558829408 | Tyler C Mcdaniel | Psychologist | 7300 N Perimeter Rd, Great Falls, MT 59402 | 2019-03-11 |
| 1356329817 | Timothy Paul Gacioch | Physician Assistant | 4300 Perimeter Rd, (341st Med Group) Bldg 2040, Room S156, Malmstrom Afb, MT 59402-0001 | 2006-01-05 |
| 1104848159 | Malmstrom Air Force Base | Military Hospital | 7300 N Perimeter Rd Bldg 2040, 341 Mdos/sgomhf Malmstrom Afb, Great Falls, MT 59402-6701 | 2006-07-25 |
| 1205837184 | Deborah M Garrity | Pediatrics | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2005-08-02 |
| Find all providers in zip 59402 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505769 | Abigail Freeman | Physician Assistant | 4046 Sunstone St Unit B, Bozeman, MT 59718-3512 | 2020-10-14 |
| 1033724307 | Jeffrey Austin | Physician Assistant | 345 Coach Ln, Hamilton, MT 59840-9041 | 2020-09-13 |
| 1316556269 | Bronte Heath Schultz | Physician Assistant | 236 15th Ave S, Great Falls, MT 59405-4254 | 2020-07-27 |
| 1285255893 | Teryn Ashli Green | Physician Assistant | 212 5th Ave, Helena, MT 59601-4204 | 2020-05-05 |
| 1669013744 | Marissa Lisette Cadena | Physician Assistant | 16305 Highland Dr, Florence, MT 59833-6068 | 2019-09-30 |
| 1891269973 | Jason Enewold | Physician Assistant | 1424 Scott St, Missoula, MT 59802-2435 | 2019-01-11 |
| 1437626751 | Janel Lea Allison-shamblin | Physician Assistant | 1232 N 15th Ave Ste 1, Bozeman, MT 59715-3299 | 2018-10-24 |
| 1730664723 | Katrin Johanna Kahl | Physician Assistant | 5005 Pattee Canyon Rd, Missoula, MT 59803-1811 | 2018-09-26 |
| 1023591757 | Kaytlin G Deveney | Physician Assistant | 305 W Porphyry St Ste 100, Butte, MT 59701-2000 | 2018-09-09 |
| 1750862876 | Brett A Steinmetz | Physician Assistant | 3525 2nd Ave S, Great Falls, MT 59405-3513 | 2018-08-27 |
| Find all providers with the same taxonomy | ||||
| City | MALMSTROM AFB |
| Zip Code | 59402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.