Healthcare Provider Details

I. General information

NPI: 1679541908
Provider Name (Legal Business Name): DIANA HESS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2006
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 ACADEMY DR
ANCHORAGE AK
99507-5391
US

IV. Provider business mailing address

8000 MENTRA ST
ANCHORAGE AK
99518-2459
US

V. Phone/Fax

Practice location:
  • Phone: 907-522-7090
  • Fax: 907-522-7095
Mailing address:
  • Phone: 907-306-5218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNURU958
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: