Active NPI
Susan Paul
- Registered Nurse
- Wasilla, AK
National Provider Identifier
1831943257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 192832
- Practice address
- 2650 E Broadview Ave
Wasilla, AK 99654-8302 - Phone
- (907) 313-1333
- NPI assigned
- Apr 12, 2024
- Last updated
- Apr 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 192832 | AK | Primary |
Addresses
Primary practice location
2650 E Broadview Ave
Wasilla, AK 99654-8302
Mailing address
357 E Parks Hwy
Wasilla, AK 99654-7005
Phone (907) 313-1333
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
| License | State | Type | Specialty |
|---|---|---|---|
| 192832 | AK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1831943257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357 E PARKS HWY",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547005",
"telephone_number": "907-313-1333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 E BROADVIEW AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "996548302",
"telephone_number": "907-313-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-12",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AK",
"license": "192832",
"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 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.