Provider Demographics
NPI:1982986972
Name:STITHAM, NASTASHA H (NP)
Entity Type:Individual
Prefix:
First Name:NASTASHA
Middle Name:H
Last Name:STITHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NASTASHA
Other - Middle Name:A
Other - Last Name:HORVATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:15 STRAWBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5941
Mailing Address - Country:US
Mailing Address - Phone:207-777-7740
Mailing Address - Fax:207-795-9342
Practice Address - Street 1:236 STETSON RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6422
Practice Address - Country:US
Practice Address - Phone:207-777-7740
Practice Address - Fax:207-795-9342
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP111075363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner