Healthcare Provider Details

I. General information

NPI: 1194451153
Provider Name (Legal Business Name): KATIE LYNN ZUPAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE LYNN BYERLY

II. Dates (important events)

Enumeration Date: 07/31/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 10TH AVE N
BILLINGS MT
59101-0703
US

IV. Provider business mailing address

3673 SPARTAN CIR
BILLINGS MT
59102-5999
US

V. Phone/Fax

Practice location:
  • Phone: 406-238-5046
  • Fax: 406-247-6053
Mailing address:
  • Phone: 406-860-9233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: