Sharon Ann Banicki, ANP

Individual provider Active NPI Nurse Practitioner · Anchorage, AK

NPI 1215044532 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1215044532
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
584 (AK)
Practice address
1200 Airport Heights Dr
Suite 280
Anchorage, AK 99508
Phone
(907) 339-9700
Fax
(907) 339-9720
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
584AKMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 584 AK Yes

Addresses

Primary practice location

1200 Airport Heights Dr
Suite 280
Anchorage, AK 99508

Mailing address

19739 War Admiral Rd
Eagle River, AK 99577
Phone (907) 696-1697

Other providers in Anchorage, AK

All providers in Anchorage, AK · Nurse Practitioner in Alaska

Sources for this page

Verify at the official NPI Registry.