Individual provider · NPI-1

J. Dette Avalon, MSN, ANP

Nurse Practitioner · Anchorage, AK

NPI number1407940760
StatusActive
Last updated in NPPESNov 25, 2015

Details

NPI
1407940760
Entity type
Individual (NPI-1)
Name
Ms. J. Dette Avalon
Credential
MSN, ANP
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 3, 2006
Last updated
Nov 25, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner944AKYes
363L00000X Nurse Practitioner308AK
363LF0000X Nurse Practitioner, Family308AK
364SH1100X Clinical Nurse Specialist, Holistic944AK
363LF0000X Nurse Practitioner, Family944AK

Practice location

3524 East 15th Ave
Anchorage, AK 99508

Phone 907-222-6601 · Fax 907-222-6602

Mailing address

3524 East 15th Ave
Anchorage, AK 99508

Phone 907-222-6601 · Fax 902-222-6602

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