Active NPI
Alice Ann Mural, ANP
- Family Nurse Practitioner
- Fairbanks, AK
National Provider Identifier
1104890391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AK277
- Practice address
- 1605 Carr Ave
Fairbanks, AK 99709-4204 - Phone
- (907) 455-4863
- NPI assigned
- Feb 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AK277 | AK | Primary |
Addresses
Primary practice location
1605 Carr Ave
Fairbanks, AK 99709-4204
Mailing address
1605 Carr Ave
Fairbanks, AK 99709-4204
Phone (907) 455-4863
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277 | AK | MD | Marriage & Family Therapist |
| AK277 | AK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raymond E. Andreassen | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Delta Junction, AK
- NPI 1366640070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1104890391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 CARR AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997094204",
"telephone_number": "907-455-4863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 CARR AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997094204",
"telephone_number": "907-455-4863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURAL",
"first_name": "ALICE",
"middle_name": "ANN",
"credential": "ANP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AK",
"license": "AK277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.