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EAGLE RIVER PAIN & WELLNESS LLC NPI 1003255480


NPI Information

NPI: 1003255480
Provider Name: EAGLE RIVER PAIN & WELLNESS, LLC
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Address:
16425 BROOKS LOOP
EAGLE RIVER, AK
ZIP 99577
Phone: (907) 622-4673
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EAGLE RIVER PAIN & WELLNESS, LLC is a nurse practitioner in Eagle River, AK. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. EAGLE RIVER PAIN & WELLNESS, LLC NPI is 1003255480. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16425 BROOKS LOOP
EAGLE RIVER, AK
ZIP 99577-027
Phone: (907) 622-4673
Fax: (907) 622-4674

The provider's authorized official is Jessica Joyce Spayd .
The authorized official title is Owner and has the following contact phone number (907) 622-4673.

The enumeration date for this NPI number is 6/19/2013 and was last updated on 6/20/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse Practitioner308947ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11584697MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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