Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 235 | AK |
NPI | 1093821415 |
---|---|
Provider Name | Leeanne K Mercier |
First Address | Anchorage, AK 99508 |
Second Address | Anchorage, AK 99508-5212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NP18893 | (05) | AK |