Healthcare Provider Details

I. General information

NPI: 1861304560
Provider Name (Legal Business Name): CHERYL S CORDIE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 OLD SEWARD HWY STE 300
ANCHORAGE AK
99503-6079
US

IV. Provider business mailing address

PO BOX 671733
CHUGIAK AK
99567-1733
US

V. Phone/Fax

Practice location:
  • Phone: 907-770-0862
  • Fax:
Mailing address:
  • Phone: 907-727-4314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberNURR25533
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: