Healthcare Provider Details

I. General information

NPI: 1538073002
Provider Name (Legal Business Name): REBEKKAH ALLEY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4961 E MAYFLOWER LN
WASILLA AK
99654-7708
US

IV. Provider business mailing address

PO BOX 2737
PALMER AK
99645-2737
US

V. Phone/Fax

Practice location:
  • Phone: 907-357-3496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: