Healthcare Provider Details

I. General information

NPI: 1093821415
Provider Name (Legal Business Name): LEEANNE K MERCIER ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 LAKE OTIS PKWY STE 105
ANCHORAGE AK
99508-5226
US

IV. Provider business mailing address

4200 LAKE OTIS PKWY STE 105
ANCHORAGE AK
99508-5226
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 Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number235
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: