Organization · NPI-2

Alaska Health Group, LLC.

Nurse Practitioner, Psych/Mental Health · Anchorage, AK

NPI number1013338425
StatusActive
Last updated in NPPESJan 2, 2014

Details

NPI
1013338425
Entity type
Organization (NPI-2)
Legal business name
Alaska Health Group, LLC.
Organization subpart
No
Enumeration date
Jan 2, 2014
Last updated
Jan 2, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental Health1121AKYes
363LF0000X Nurse Practitioner, Family1121AK

Practice location

12945 Norak Pl
Anchorage, AK 99516-2883

Phone 907-830-9225

Mailing address

205 E Dimond Blvd # 166
Anchorage, AK 99515-1909

Authorized official

Daniel Wiese
Member/Partner
9078309225

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