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General NPI Number Information
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NPI Number | 1053275545
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Entity Type | Organization
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Legal Business Name | FEISTY MARMOT, LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1867 AIRPORT WAY STE 215
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City | FAIRBANKS
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State | AK
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Zip | 99701-4062
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Country | US
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Telephone | 865-474-0323
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82163
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City | FAIRBANKS
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State | AK
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Zip | 99708-2163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHANIE KAY RAST
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Credential |
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Telephone | 865-474-0323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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