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NPI Code Detail

MEDICARE: GRACIE RIELLE MINNICK-WHALEY

MEDICARE:   GRACIE RIELLE MINNICK-WHALEY
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1174485676
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACIE RIELLE MINNICK-WHALEY
Provider Business Mailing Address
First Line : PO BOX 1907
Second Line :
City : PALMER
State : AK
Zip : 99645-1907
Country : US
Telephone Number : 907-745-2634
Fax Number : 907-745-4897
Provider Business Practice Location Address
First Line : 11921 E PALMER WASILLA HWY
Second Line :
City : PALMER
State : AK
Zip : 99645-8833
Country : US
Telephone Number : 907-745-2634
Fax Number : 907-745-4897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ GRACIE RIELLE MINNICK-WHALEY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.