GHEDAIR MENTAL WELLNESS NPI 1114501764

NPI Information

  • NPI: 1114501764
  • Provider Name: GHEDAIR MENTAL WELLNESS
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 220 E SPRUCE AVE
    WASILLA, AK
    ZIP 99654
  • Phone: (907) 841-4073

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NPI Details

GHEDAIR MENTAL WELLNESS is a psychiatric/mental health nurse practitioner in Wasilla, AK. GHEDAIR MENTAL WELLNESS NPI is 1114501764. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

220 E SPRUCE AVE
WASILLA, AK
ZIP 99654-854
Phone: (907) 841-4073

The provider's authorized official is Amber R Shea .
The authorized official title is Owner and has the following contact phone number (907) 841-4073.

The enumeration date for this NPI number is 5/10/2021 and was last updated on 5/10/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

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: 11/21/2025

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