Provider Demographics
NPI:1336537299
Name:SVEJKOVSKY, TRISTAN ASHLEY (FNP-BC)
Entity type:Individual
Prefix:
First Name:TRISTAN
Middle Name:ASHLEY
Last Name:SVEJKOVSKY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 FOUR MILE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-0907
Mailing Address - Country:US
Mailing Address - Phone:406-299-2004
Mailing Address - Fax:406-299-2054
Practice Address - Street 1:1720 FOUR MILE VIEW RD
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-0907
Practice Address - Country:US
Practice Address - Phone:406-299-2004
Practice Address - Fax:406-299-2054
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100807363LF0000X
MT38130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily