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General NPI Number Information
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NPI Number | 1699842989
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Entity Type | Individual
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Provider Name | TINA M PLEASANTS FNP
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 3220 HOSPITAL DR STE 101
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City | JUNEAU
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State | AK
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Zip | 99801-7899
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Country | US
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Telephone | 907-364-2668
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35322
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City | JUNEAU
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State | AK
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Zip | 99803-5322
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Country | US
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Telephone | 907-500-9033
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1197
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License Number State | AK
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