Healthcare Provider Details

I. General information

NPI: 1245984053
Provider Name (Legal Business Name): ANA ALEJANDRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 08/29/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JBER 5955 ZEAMER AVE
ANCHORAGE AK
99506
US

IV. Provider business mailing address

JBER 5955 ZEAMER AVE
ANCHORAGE AK
99506
US

V. Phone/Fax

Practice location:
  • Phone: 907-550-2181
  • Fax:
Mailing address:
  • Phone: 907-550-2181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3014
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: