Gary Eaker

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

119593 Issued in AK

Practice address

1717 W Cowles St
Fairbanks, AK 99701-5926

Phone

(907) 451-6682

NPI assigned

Jul 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1790339695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 106",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015926",
            "telephone_number": "907-451-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKER",
        "first_name": "GARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "119593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Licensed Practical Nurse in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.