Healthcare Provider Details

I. General information

NPI: 1679281471
Provider Name (Legal Business Name): MARIE BADJAN FORSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIE BADJAN

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 E TUDOR RD STE 103
ANCHORAGE AK
99507-1166
US

IV. Provider business mailing address

5644 E 40TH AVE UNIT G202
ANCHORAGE AK
99504-5335
US

V. Phone/Fax

Practice location:
  • Phone: 907-770-5864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number249592
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: