Healthcare Provider Details

I. General information

NPI: 1598687576
Provider Name (Legal Business Name): HANNAH HVIZDZAK APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 FORT MISSOULA RD STE 232
MISSOULA MT
59804-7479
US

IV. Provider business mailing address

9613 LIAM LOOP UNIT A
MISSOULA MT
59808-8878
US

V. Phone/Fax

Practice location:
  • Phone: 406-523-5650
  • Fax:
Mailing address:
  • Phone: 478-302-9396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-288624
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: