Healthcare Provider Details

I. General information

NPI: 1174164875
Provider Name (Legal Business Name): CHRISTIAAN FS COLLIER NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CHANNEL DR STE 300
JUNEAU AK
99801-7837
US

IV. Provider business mailing address

PO BOX 3507
SEATTLE WA
98124-3507
US

V. Phone/Fax

Practice location:
  • Phone: 907-463-4000
  • Fax: 907-463-4075
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number171643
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: