Healthcare Provider Details

I. General information

NPI: 1225834740
Provider Name (Legal Business Name): NEVE MARIE MICHAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NEVE MARIE SELF

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 E BOGARD RD
WASILLA AK
99654-4711
US

IV. Provider business mailing address

2801 E PALMER WASILLA HWY STE A
WASILLA AK
99654-7339
US

V. Phone/Fax

Practice location:
  • Phone: 907-373-4732
  • Fax:
Mailing address:
  • Phone: 907-373-5331
  • Fax: 907-373-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: