Kyndall Ampy Blackburn
Individual provider Active NPI Peer Specialist · Fairbanks, AK
NPI 1417875436 · NPPES record last updated Jul 7, 2026
Key facts
- NPI
- 1417875436
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 909 Cushman St Ste 103
Fairbanks, AK 99701-4668 - Phone
- (907) 456-4610
- NPI assigned
- Jul 7, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Hope Center | Peer Specialist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | AK | Yes |
Addresses
Primary practice location
909 Cushman St Ste 103
Fairbanks, AK 99701-4668
Mailing address
PO Box 73189
Fairbanks, AK 99707-3189
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2026. 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.