Healthcare Provider Details

I. General information

NPI: 1669735882
Provider Name (Legal Business Name): JOSCELYN VANDUREN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 PIPER ST ULL002
ANCHORAGE AK
99508
US

IV. Provider business mailing address

PO BOX 3991
SEATTLE WA
98124-3991
US

V. Phone/Fax

Practice location:
  • Phone: 907-212-3186
  • Fax: 907-212-3665
Mailing address:
  • Phone: 907-212-3186
  • Fax: 907-212-3665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNUR U 1305
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR R 25025
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: