Provider Demographics
NPI:1376619429
Name:NAST, VICTORIA B (ARNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:B
Last Name:NAST
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-0456
Mailing Address - Country:US
Mailing Address - Phone:603-436-7588
Mailing Address - Fax:603-431-0451
Practice Address - Street 1:559 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:GREENLAND
Practice Address - State:NH
Practice Address - Zip Code:03840-2251
Practice Address - Country:US
Practice Address - Phone:603-436-7588
Practice Address - Fax:603-431-0451
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0239362393363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30001417Medicaid
NHNP3667Medicare ID - Type Unspecified
NHP48667Medicare UPIN