Healthcare Provider Details

I. General information

NPI: 1407787054
Provider Name (Legal Business Name): AMANDA GILL BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3730 RHONE CIR STE 101
ANCHORAGE AK
99508-5054
US

IV. Provider business mailing address

PO BOX 220533
ANCHORAGE AK
99522-0533
US

V. Phone/Fax

Practice location:
  • Phone: 907-561-5152
  • Fax:
Mailing address:
  • Phone: 907-244-9495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number242103
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: