Organization · NPI-2

Advanced Weight Loss & Wellness Center Of Alaska,llc

Nurse Practitioner, Family · Anchorage, AK

NPI number1992496590

StatusActive

Last updated in NPPESMay 16, 2023

Details

NPI: 1992496590
Entity type: Organization (NPI-2)
Legal business name: Advanced Weight Loss & Wellness Center Of Alaska,llc
Organization subpart: No
Enumeration date: May 16, 2023
Certification date: May 16, 2023
Last updated: May 16, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	–	–	Yes
163W00000X	Registered Nurse	–	–
171400000X	Health & Wellness Coach	–	–
207K00000X	Allergy & Immunology	–	–
207N00000X	Dermatology	–	–
207Q00000X	Family Medicine	–	–
207RN0300X	Internal Medicine, Nephrology	–	–
261QI0500X	Clinic/Center, Infusion Therapy	–	–
363AM0700X	Physician Assistant, Medical	–	–
363LW0102X	Nurse Practitioner, Women's Health	–	–

Practice location

135 W Dimond Blvd Ste 104w
Anchorage, AK 99515-1907

Phone 907-240-3376 · Fax 907-563-7929

Mailing address

200 West 34th Avenue
Pmb 1008
Anchorage, AK 99503

Phone 907-744-7110 · Fax 907-563-7929

Authorized official

Amber Nicole Brophy-King
Administrator
9077447110

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