Healthcare Provider Details

I. General information

NPI: 1073536876
Provider Name (Legal Business Name): DENISE C VALENTINE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. DENISE C EKSTROM

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3841 PIPER ST SUITE T-100
ANCHORAGE AK
99508-4624
US

IV. Provider business mailing address

PO BOX 200149
ANCHORAGE AK
99520-0149
US

V. Phone/Fax

Practice location:
  • Phone: 907-561-3211
  • Fax: 907-562-7547
Mailing address:
  • Phone: 907-561-3211
  • Fax: 907-562-7547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0050012711
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number876
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: