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NPI Code Detail

MEDICARE: DR. MARTHA JANE HERRIOTT PHD, ANP

MEDICARE: DR. MARTHA JANE HERRIOTT PHD, ANP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner873AK

General Provider Information

NPI Number : 1427171800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTHA JANE HERRIOTT PHD, ANP
Provider Business Mailing Address
First Line : PO BOX 211296
Second Line :
City : ANCHORAGE
State : AK
Zip : 99521-1296
Country : US
Telephone Number : 907-279-8111
Fax Number : 907-272-4850
Provider Business Practice Location Address
First Line : 821 N ST STE 102
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3285
Country : US
Telephone Number : 907-279-8111
Fax Number : 907-272-4850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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