Healthcare Provider Details

I. General information

NPI: 1528250826
Provider Name (Legal Business Name): SHERRY D NELSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AIRPORT WAY
ILIAMNA AK
99606-9800
US

IV. Provider business mailing address

7033 E TUDOR RD
ANCHORAGE AK
99507-1262
US

V. Phone/Fax

Practice location:
  • Phone: 907-571-1818
  • Fax:
Mailing address:
  • Phone: 907-729-7269
  • Fax: 907-729-5180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPADA477
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: