Most Relevant Information
Provider Data
| NPI Number: | 1003486002 |
| Provider Name: | STEPHANIE K EASTBURN PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 99517 |
Most Important Dates
| Enumeration Date: | 06/30/2021 |
| Last Updated: | 06/30/2021 |
Provider Practice Location
320 SUNNYVIEW LN
KALISPELL
MT
599013129
Practice Location Phone/Fax
| Phone: | 4067527441 |
| Fax: | 4062570304 |
Provider Mailing Location
320 SUNNYVIEW LN
KALISPELL
MT
599013129
Provider Mailing Phone/Fax
| Phone: | 4067527441 |
| Fax: | 4062570304 |