Healthcare Provider Details

I. General information

NPI: 1891924163
Provider Name (Legal Business Name): AVANTE MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 W NORTHERN LIGHTS BLVD
ANCHORAGE AK
99503-2408
US

IV. Provider business mailing address

915 WEST NORTHERN LIGHTS BOULEVARD
ANCHORAGE AK
99503
US

V. Phone/Fax

Practice location:
  • Phone: 907-770-6700
  • Fax: 907-770-6707
Mailing address:
  • Phone: 907-770-6700
  • Fax: 907-770-6707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: EMILY WEIMER
Title or Position: BILLING MANAGER
Credential:
Phone: 907-770-6700