Healthcare Provider Details

I. General information

NPI: 1588522411
Provider Name (Legal Business Name): AURORA NOVA CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 W NORTHERN LIGHTS BLVD
ANCHORAGE AK
99503-2503
US

IV. Provider business mailing address

3300 ARCTIC BLVD STE 201
ANCHORAGE AK
99503-4579
US

V. Phone/Fax

Practice location:
  • Phone: 907-921-9370
  • Fax: 907-268-2113
Mailing address:
  • Phone: 949-212-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JERRY FRANCISCO BENZL
Title or Position: PRESIDENT
Credential: MD
Phone: 949-212-0999