Healthcare Provider Details

I. General information

NPI: 1992529341
Provider Name (Legal Business Name): KATIE ANNE ZAGAR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE ANNE REDDING RN

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34300 S TALKEETNA SPUR
TALKEETNA AK
99676-9709
US

IV. Provider business mailing address

34300 S TALKEETNA SPUR
TALKEETNA AK
99676-9709
US

V. Phone/Fax

Practice location:
  • Phone: 907-733-2273
  • Fax:
Mailing address:
  • Phone: 907-733-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNURR37948
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: