Healthcare Provider Details

I. General information

NPI: 1609659234
Provider Name (Legal Business Name): CATHERINE REYES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 L ST
ANCHORAGE AK
99501-3337
US

IV. Provider business mailing address

16404 NOBLE POINT DR
ANCHORAGE AK
99516-7514
US

V. Phone/Fax

Practice location:
  • Phone: 907-343-6718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number212773
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: