Alaska Pediatric Night Clinic, Inc.
Organization Active NPI Pediatrics Physician · Eagle River, AK
NPI 1124558044 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1124558044
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 113174 (AK)
- Legal business name
- ALASKA PEDIATRIC NIGHT CLINIC, INC.
- Practice address
- 20209 Eagle River Rd
Eagle River, AK 99577-6800 - Phone
- (907) 201-7801
- NPI assigned
- Jun 13, 2017
- Organization subpart
- No
Authorized official
- Name
- Jennifer Austin, CPNP
- Title
- Ceo
- Phone
- (907) 201-7801
Practitioners 11
-
Jacob Eby, M.D.
-
Stephanie Anne Olah Packard, APRN, FNP-BC
-
Sheryl Sue Cohen, M.D.
-
Glenda H Grawe, MD
-
Erika Beth Mark, DO
-
Christine Yoo, NP
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 113174 | AK | Yes |
Addresses
Primary practice location
20209 Eagle River Rd
Eagle River, AK 99577-6800
Mailing address
20209 Eagle River Rd
Eagle River, AK 99577-6800
Phone (907) 201-7801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129450 | Medicaid | AK |
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- Alaska Oral Surgery Group, P.C.
- Alaska Psychology LLC
- Alaska Social Work & Nursing Consortium,LLC
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- Alba Behavioral Health
- Rachel Carina Alexander
All providers in Eagle River, AK · Pediatrics Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.