Healthcare Provider Details

I. General information

NPI: 1992932503
Provider Name (Legal Business Name): WOMEN'S HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 LAKE OTIS PKWY SUITE 204 B
ANCHORAGE AK
99508-5223
US

IV. Provider business mailing address

4050 LAKE OTIS PKWY SUITE 204 B
ANCHORAGE AK
99508-5223
US

V. Phone/Fax

Practice location:
  • Phone: 907-929-9586
  • Fax: 907-929-3836
Mailing address:
  • Phone: 907-929-9586
  • Fax: 907-929-3836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number235
License Number StateAK

VIII. Authorized Official

Name: MS. LEEANNE MERCIER
Title or Position: OWNDER
Credential: ANP
Phone: 907-929-9586