HEIDE PROVENCHER

ANCHORAGE, AK
NPI1801228788
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AK  1343)
Enumeration Date2013-08-02
Last Update Date2020-10-02
Business Address
HEIDE PROVENCHER ANP
4200 LAKE OTIS PKWY
ANCHORAGE, AK 99508-5226
Phone number: 907-338-2273
Mailing Address
HEIDE PROVENCHER ANP
2437 INGRA ST
ANCHORAGE, AK 99508-3945
Phone number: 907-227-6610
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