Provider Demographics
NPI:1104523562
Name:KASPERICK, HANNAH (FNP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:KASPERICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3426 S MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-3156
Mailing Address - Country:US
Mailing Address - Phone:406-490-7675
Mailing Address - Fax:
Practice Address - Street 1:435 S CRYSTAL ST STE 300
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1506
Practice Address - Country:US
Practice Address - Phone:406-496-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-212909363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner