Individual provider Active NPI

Alice Ann Mural, ANP

  • Family Nurse Practitioner
  • Fairbanks, AK
National Provider Identifier
1104890391
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AK277 Issued in AK
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

Updated by the provider on Feb 8, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
277AKMDMarriage & Family Therapist
AK277AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.