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NPI Code Detail

MEDICARE: NICOLE MAZUR LPN

MEDICARE: NICOLE MAZUR LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse238477AK

General Provider Information

NPI Number : 1053268110
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MAZUR LPN
Provider Business Mailing Address
First Line : 1015 E 6TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-2748
Country : US
Telephone Number : 907-276-6430
Fax Number : 907-276-3637
Provider Business Practice Location Address
First Line : 1015 E 6TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-2748
Country : US
Telephone Number : 907-276-6430
Fax Number : 907-276-3637
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ NICOLE MAZUR LPN” Practice Location

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