Individual provider Active NPI

Elaine Marquez-Haggerty

  • Registered Nurse
  • Wasilla, AK
National Provider Identifier
1477948644
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
17904 Issued in AK
Practice address
3223 E Palmer Wasilla Hwy Ste 3
Mat-Su Public Health Center
Wasilla, AK 99654
Phone
(907) 352-6600
Fax
(907) 376-3096
NPI assigned
Apr 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 17904 AK Primary

Addresses

Primary practice location

3223 E Palmer Wasilla Hwy Ste 3
Mat-Su Public Health Center
Wasilla, AK 99654

Mailing address

3223 E Palmer Wasilla Hwy #3
Mat-Su Public Health Center
Wasilla, AK 99654
Phone (907) 352-6600

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17904AKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
State of Alaska Past Accepting new patients
State of Alaska Department of Administration Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1477948644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 E PALMER WASILLA HWY #3",
            "address_2": "MAT-SU PUBLIC HEALTH CENTER",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-352-6600",
            "fax_number": "907-376-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 E PALMER WASILLA HWY STE 3",
            "address_2": "MAT-SU PUBLIC HEALTH CENTER",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-352-6600",
            "fax_number": "907-376-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ-HAGGERTY",
        "first_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "17904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.