| NPI | 1114681608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALEY EVENS Authorized Official 907-455-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| 207Q00000X Family Medicine | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2025-09-04 |