Alpine Medical Group LLC
Nurse Practitioner, Family in Fairbanks, AK. Organization (NPI-2).
NPI number1114681608
StatusActive
Last updated in NPPESSep 4, 2025
Details
- NPI
- 1114681608
- Entity type
- Organization (NPI-2)
- Legal business name
- Alpine Medical Group LLC
- Organization subpart
- No
- Enumeration date
- Oct 29, 2021
- Certification date
- Sep 4, 2025
- Last updated
- Sep 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 363LP0200X | Nurse Practitioner, Pediatrics | – | – | |
| 363A00000X | Physician Assistant | – | – |
Practice location
605 Chief Thomas DrFairbanks, AK 99709-4848
Phone 907-455-4555 · Fax 833-941-2349
Mailing address
605 Chief Thomas DrFairbanks, AK 99709-4848
Phone 907-455-4555 · Fax 833-941-2349
Other practice locations
2054 30th Ave
Fairbanks, AK 99701-7316
Fairbanks, AK 99701-7316
Phone 907-455-4555 · Fax 833-941-2349
Authorized official
Haley Evens
Authorized Official
9074554555
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