=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255217584
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEPHANIE CURTIS BSN, RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2025
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1201 N MULDOON RD
-----------------------------------------------------
City | ANCHORAGE
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99504-6104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-201-3136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18100 MULDROW ST
-----------------------------------------------------
City | EAGLE RIVER
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99577-7501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-233-3696
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine Registered Nurse
-----------------------------------------------------
License Number | 113817
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------