Healthcare Provider Details

I. General information

NPI: 1922894518
Provider Name (Legal Business Name): JASON BIBEE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E DIMOND BLVD STE 3-520
ANCHORAGE AK
99515-2044
US

IV. Provider business mailing address

PO BOX 72376
FAIRBANKS AK
99707-2376
US

V. Phone/Fax

Practice location:
  • Phone: 907-374-0852
  • Fax: 907-374-0854
Mailing address:
  • Phone: 907-374-0852
  • Fax: 907-374-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number30266
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number258419
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: