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NPI Code Detail

MEDICARE: GRACE LYNN CONVERSE

MEDICARE: GRACE LYNN CONVERSE
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
1172V00000XCommunity Health WorkerAK

General Provider Information

NPI Number : 1891627378
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE LYNN CONVERSE
Provider Business Mailing Address
First Line : 1915 SOUTHERN AVE
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-4236
Country : US
Telephone Number : 907-385-6183
Fax Number :
Provider Business Practice Location Address
First Line : 1825 MARIKA RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5521
Country : US
Telephone Number : 907-385-6183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ GRACE LYNN CONVERSE ” 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.

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