Healthcare Provider Details

I. General information

NPI: 1689261190
Provider Name (Legal Business Name): NEVELLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19436 KULLBERG DR
CHUGIAK AK
99567-6381
US

IV. Provider business mailing address

PO BOX 670117
CHUGIAK AK
99567-0117
US

V. Phone/Fax

Practice location:
  • Phone: 907-441-8817
  • Fax: 833-370-0295
Mailing address:
  • Phone: 907-441-8817
  • Fax: 833-370-0295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JULIANN NEVELLS
Title or Position: OWNER
Credential: OTR/L
Phone: 907-441-8817