Healthcare Provider Details

I. General information

NPI: 1376197616
Provider Name (Legal Business Name): KARL NADON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 E CARNEY RD
WASILLA AK
99654-9007
US

IV. Provider business mailing address

1990 E CARNEY RD
WASILLA AK
99654-9007
US

V. Phone/Fax

Practice location:
  • Phone: 907-350-8702
  • Fax:
Mailing address:
  • Phone: 907-350-8702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number208118
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: