Provider Demographics
NPI:1497008437
Name:BYRD, ZETTA (RN)
Entity Type:Individual
Prefix:
First Name:ZETTA
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ZETTA
Other - Middle Name:
Other - Last Name:OSTRANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 812
Mailing Address - Street 2:
Mailing Address - City:KASILOF
Mailing Address - State:AK
Mailing Address - Zip Code:99610-0812
Mailing Address - Country:US
Mailing Address - Phone:907-260-6947
Mailing Address - Fax:
Practice Address - Street 1:250 HOSPITAL PL
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7559
Practice Address - Country:US
Practice Address - Phone:907-714-4404
Practice Address - Fax:907-714-4696
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK9858163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care