MEDICARE: ALASKA NEURODIAGNOSTICS SPECIALISTS LLC

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	246ZE0500X	EEG Specialist/Technologist

General Provider Information

NPI Number	:	1982301073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALASKA NEURODIAGNOSTICS SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	911 W 8TH AVE SUITE 101 BOX 38
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501
Country	:	US
Telephone Number	:	907-982-3114
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 W 8TH AVE STE 101
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-3340
Country	:	US
Telephone Number	:	907-982-3114
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	KARRA RACHEL PAULSEN
Credential	:	R. EEG T.
Telephone Number	:	907-982-3114

Provider Enumeration Date	:	02/09/2023
Last Update Date	:	12/17/2024

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