Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 951 | AK |
Y | 363L00000X | Nurse Practitioner | 951 | AK |
NPI | 1164600185 |
---|---|
Provider Name | Margaret Rader |
First Address | Fairbanks, AK 99707-3720 |
Second Address | Fairbanks, AK 99701-5903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2008 |
Last Update Date | 22/01/2019 |