HEIDE PROVENCHER

HOPE, AK
NPI1801228788
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: AK  1343)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: AK  1343)
Enumeration Date2013-08-02
Last Update Date2026-02-18
Business Address
HEIDE PROVENCHER APRN
PO BOX 174
HOPE, AK 99605-0174
Phone number: 907-227-6610
Mailing Address
HEIDE PROVENCHER APRN
2437 INGRA ST
ANCHORAGE, AK 99508-3945
Phone number: 907-227-6610