Alexa Breanne Pullen, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

229812 Issued in AK

Practice address

19239 Darby Rd
Eagle River, AK 99577

Phone

(907) 854-4482

NPI assigned

Apr 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dopanine LLC

  • Registered Dietitian
  • Eagle River, AK
  • NPI 1740846807

  Nutritionist

  NPD Authorized official
• Altair Integrative Wellness

  • Sports Physician Chiropractor
  • Wasilla, AK
  • NPI 1932744836
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1235792177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 BUSINESS BLVD STE 6",
            "address_2": "PMB 189",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777798",
            "telephone_number": "907-854-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19239 DARBY RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "99577",
            "telephone_number": "907-854-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "ALEXA",
        "middle_name": "BREANNE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "AK",
            "license": "145169",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86980",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "229812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Levi Marc Porter, O.D.
• Naysa Leigh Poshusta, D.V.M.
• Shannon Marie Post, PTA
• Jayme Kay Powers, LMT
• Julieann Pruitt
• Kimberly Kay Pullen, MS
• Rita Jane Purcell, CCC-SLP
• Heidi Quimby, MSW
• Melodie Celeste Radcliffe, BCBA
• Emily Grace Radewahn, BA, BCABA

• Registered Dietitian in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Registered Dietitian in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.