Eagle River Behavioral Health, LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Eagle River, AK
NPI 1366062903 · NPPES record last updated May 1, 2023
Key facts
- NPI
- 1366062903
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- EAGLE RIVER BEHAVIORAL HEALTH, LLC
- Practice address
- 12812 Old Glenn Hwy Ste C4
Eagle River, AK 99577-7002 - Phone
- (907) 726-0378
- Fax
- (907) 726-0374
- NPI assigned
- Apr 23, 2020
- Organization subpart
- No
Authorized official
- Name
- Zan Whitman, ARNP
- Title
- Provider
- Phone
- (907) 726-0378
National Provider Directory
Locations
12812 Old Glenn Hwy
Ste C4
Eagle River, AK 99577
Phone (907) 696-5901
10928 Eagle River Rd
Ste 210
Eagle River, AK 99577
Phone (907) 302-5766
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
12812 Old Glenn Hwy Ste C4
Eagle River, AK 99577-7002
Mailing address
PO Box 770870
Eagle River, AK 99577-0870
Phone (907) 290-7033
Other practice location 1
10928 Eagle River Rd Ste 210
Eagle River, AK 99577-8078
Phone (907) 726-0378
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240808 | Medicaid | AK |
Other providers in Eagle River, AK
- Jacqueline Duffield
- Elizabeth Claire Dufour
- Kathleen Dye
- Eagle River Acupuncture LLC.
- Eagle River Behavioral Health
- Eagle River Dermatology Inc
- Eagle River Pain & Wellness, LLC
- Eagle River Primary Care
- Eagle River Therapeutic Massage LLC
- Eagle River Vision Clinic Inc
All providers in Eagle River, AK · Psychiatric/Mental Health Nurse Practitioner in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2023. 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.