Healthcare Provider Details

I. General information

NPI: 1669090361
Provider Name (Legal Business Name): WOMEN'S WELLNESS AT THE NEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 E 42ND AVE
ANCHORAGE AK
99508-5206
US

IV. Provider business mailing address

2400 E 42ND AVE
ANCHORAGE AK
99508-5206
US

V. Phone/Fax

Practice location:
  • Phone: 907-770-8555
  • Fax:
Mailing address:
  • Phone: 907-770-8555
  • Fax: 844-831-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA ELAINE NORTON
Title or Position: PRESIDENT
Credential: CNM
Phone: 907-770-8555