Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 170 | AK |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | ANPLIC#170 | AK |
NPI | 1033148028 |
---|---|
Provider Name | Ms. Barbara A. Maryan |
First Address | Anchorage, AK 99503 |
Second Address | Anchorage, AK 99503-4039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 22/12/2011 |