Healthcare Provider Details

I. General information

NPI: 1104769157
Provider Name (Legal Business Name): NAOMI FIFE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DEBARR CIR
ANCHORAGE AK
99508-2984
US

IV. Provider business mailing address

1500 DEBARR CIR
ANCHORAGE AK
99508-2984
US

V. Phone/Fax

Practice location:
  • Phone: 907-865-7105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number238413
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: