MEDICARE: ANNELIESE NIEDERHAUSER

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
1	163W00000X	Registered Nurse	1649935	CO
2	163W00000X	Registered Nurse	95279599	CA
3	163W00000X	Registered Nurse	200495	AK

General Provider Information

NPI Number	:	1346196078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNELIESE NIEDERHAUSER

Provider Business Mailing Address
First Line	:	4000 OLD SEWARD HWY STE 300
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-6079
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 OLD SEWARD HWY STE 300
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-6079
Country	:	US
Telephone Number	:	907-770-0862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “ ANNELIESE NIEDERHAUSER ” Practice Location

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