Provider Demographics
NPI:1912923509
Name:ASTRUP, NANCY JEAN (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
Last Name:ASTRUP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JEAN
Other - Last Name:LIFKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1532 ELLIS ST
Mailing Address - Street 2:STE 201
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8808
Mailing Address - Country:US
Mailing Address - Phone:406-587-4501
Mailing Address - Fax:406-587-3919
Practice Address - Street 1:1532 ELLIS ST
Practice Address - Street 2:STE 201
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8808
Practice Address - Country:US
Practice Address - Phone:406-587-4501
Practice Address - Fax:406-587-3919
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT355 PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0343083Medicaid
MT000062040OtherBCBS MT
MTM000005869OtherMEDICARE
MTP00133459OtherRAILROAD MEDICARE