Julie Dittman
Individual provider Active NPI Registered Nurse · Big Lake, AK
NPI 1679995435 · NPPES record last updated Jan 14, 2014
Key facts
- NPI
- 1679995435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 32843 (AK)
- Practice address
- 14988 W. Fireweed Dr.
Big Lake, AK 99652 - Phone
- (907) 232-9055
- NPI assigned
- Jan 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32843 | AK | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 32843 | AK | Yes |
Addresses
Primary practice location
14988 W. Fireweed Dr.
Big Lake, AK 99652
Mailing address
14988 W. Fireweed Dr.
Big Lake, AK 99652
Phone (907) 232-9055
Other providers in Big Lake, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2014. 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.