Healthcare Provider Details

I. General information

NPI: 1457685166
Provider Name (Legal Business Name): RABIA AZRA BIRKLAND NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 11/29/2024
Certification Date: 11/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 HOSPITAL DR
JUNEAU AK
99801-7863
US

IV. Provider business mailing address

1002 KENDALE CIR
CHESAPEAKE VA
23322-6872
US

V. Phone/Fax

Practice location:
  • Phone: 907-321-4095
  • Fax:
Mailing address:
  • Phone: 757-816-8434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number220859
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26840
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: