Basic Information
| Provider Information | |||||||||
| NPI: | 1528358363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HASTINGS | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1211 S RESERVE ST | ||||||||
| Address2: | SUITE101 | ||||||||
| City: | MISSOULA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598013102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8406327305 | ||||||||
| FaxNumber: | 4063273231 | ||||||||
| Practice Location | |||||||||
| Address1: | 1211 S RESERVE ST | ||||||||
| Address2: | SUITE101 | ||||||||
| City: | MISSOULA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598013102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8406327305 | ||||||||
| FaxNumber: | 4063273231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2011 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MED-PHYS-LIC-49926 | MT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.