Healthcare Provider Details

I. General information

NPI: 1336064427
Provider Name (Legal Business Name): MONICA MARIE RIOS-MARRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA RIOS

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 LAKE OTIS PKWY
ANCHORAGE AK
99508-5229
US

IV. Provider business mailing address

2538 N COTTAGE HILL DR
PALMER AK
99645-9146
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-2873
  • Fax:
Mailing address:
  • Phone: 859-552-8523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number256311
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: