Healthcare Provider Details

I. General information

NPI: 1265407522
Provider Name (Legal Business Name): AMY LASHER ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY HOLLIDAY ANP

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 30TH AVE
FAIRBANKS AK
99701-7423
US

IV. Provider business mailing address

1626 30TH AVE
FAIRBANKS AK
99701-7423
US

V. Phone/Fax

Practice location:
  • Phone: 907-479-7701
  • Fax: 907-479-7718
Mailing address:
  • Phone: 907-479-7701
  • Fax: 907-479-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number656
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number656
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: