Provider Demographics
NPI:1790150860
Name:HASTIE, ANASTASIA A (PA)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:A
Last Name:HASTIE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANASTASIA
Other - Middle Name:A
Other - Last Name:JDANOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3100 WELLONS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5247
Mailing Address - Country:US
Mailing Address - Phone:252-634-9000
Mailing Address - Fax:252-634-9001
Practice Address - Street 1:3100 WELLONS BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5247
Practice Address - Country:US
Practice Address - Phone:252-634-9000
Practice Address - Fax:252-634-9001
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06180363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant