Healthcare Provider Details

I. General information

NPI: 1568793404
Provider Name (Legal Business Name): KARI IVANY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARI GERDES

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 DIPLOMACY DR
ANCHORAGE AK
99508
US

IV. Provider business mailing address

7033 E TUDOR ROAD
ANCHORAGE AK
99507
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-3300
  • Fax:
Mailing address:
  • Phone: 303-602-8340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1122
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP 60415093
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1122
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: