Individual provider Active NPI

Kristen Alcorn, NP

  • Family Nurse Practitioner
  • Palmer, AK
National Provider Identifier
1710763537
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
208760 Issued in AK
Practice address
425 E Dahlia Ave Ste J
Palmer, AK 99645-6463
Phone
(907) 746-1521
NPI assigned
Sep 6, 2023
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 208760 AK Primary

Addresses

Primary practice location

425 E Dahlia Ave Ste J
Palmer, AK 99645-6463

Mailing address

425 E Dahlia Ave Ste J
Palmer, AK 99645-6463
Phone (907) 746-1521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018003469 AK Practitioner - Nurse Practitioner 9739534207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC CurrentSince May 1, 2024 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince May 1, 2024 Accepting new patients

Locations

3066 E Meridian Park Loop
Ste 2
Wasilla, AK 99654
Phone (907) 333-2133

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1710763537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E DAHLIA AVE STE J",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456463",
            "telephone_number": "907-746-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E DAHLIA AVE STE J",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456463",
            "telephone_number": "907-746-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCORN",
        "first_name": "KRISTEN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "208760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

Verify at the official NPI Registry.