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General NPI Number Information
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NPI Number | 1285510461
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Entity Type | Individual
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Provider Name | WILLIAM IVORY RN
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Gender | Male
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 3511 W 31ST AVE
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City | ANCHORAGE
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State | AK
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Zip | 99517-1656
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Country | US
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Telephone | 307-258-3163
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Fax |
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Provider Business Mailing Address
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Address Line | 3511 W 31ST AVE
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City | ANCHORAGE
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State | AK
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Zip | 99517-1656
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Country | US
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Telephone | 307-258-3163
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | NURR35055
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License Number State | AK
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