Provider Demographics
NPI:1588254171
Name:HAN, NASTASTIA BYRD (APRN- PNP- PC)
Entity type:Individual
Prefix:
First Name:NASTASTIA
Middle Name:BYRD
Last Name:HAN
Suffix:
Gender:F
Credentials:APRN- PNP- PC
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:160 HERITAGE WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3127
Mailing Address - Country:US
Mailing Address - Phone:406-871-6226
Mailing Address - Fax:406-758-7925
Practice Address - Street 1:160 HERITAGE WAY STE 103
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3127
Practice Address - Country:US
Practice Address - Phone:406-871-6226
Practice Address - Fax:406-758-7925
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2022-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT172616363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics