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General NPI Number Information
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NPI Number | 1720189889
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Entity Type | Individual
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Provider Name | MARJORIE GRIERSON ALLAN A.N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1919 LATHROP ST STE 100
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City | FAIRBANKS
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State | AK
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Zip | 99701-5937
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Country | US
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Telephone | 907-452-1761
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Fax |
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Provider Business Mailing Address
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Address Line | 280 CRYSTAL RD
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City | FAIRBANKS
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State | AK
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Zip | 99712-1248
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Country | US
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Telephone | 907-456-6637
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 202
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License Number State | AK
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