Healthcare Provider Details

I. General information

NPI: 1528437605
Provider Name (Legal Business Name): SHERRY GONIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2015
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
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

12248 VISTA RIDGE LOOP
EAGLE RIVER AK
99577-7047
US

V. Phone/Fax

Practice location:
  • Phone: 907-770-0862
  • Fax:
Mailing address:
  • Phone: 907-500-2739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number152255
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: