GLACIER PEDIATRICS LLC NPI 1558500694

NPI Information

NPI: 1558500694
Provider Name: GLACIER PEDIATRICS, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 02D0641335

Address:
1600 GLACIER AVE
JUNEAU, AK
ZIP 99801
Phone: (907) 586-1542
Get Directions

GLACIER PEDIATRICS, LLC is a primary care clinic center in Juneau, AK. GLACIER PEDIATRICS, LLC NPI is 1558500694. The provider is registered as an organization entity type.

The provider's business location address is:

1600 GLACIER AVE
JUNEAU, AK
ZIP 99801-430
Phone: (907) 586-1542
Fax: (907) 586-1849

The provider's authorized official is Maryellen Arovold .
The authorized official title is Advanced Nurse Practioner and has the following contact phone number (907) 586-1542.

The CLIA number assigned to this NPI record is 02D0641335 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2009 and was last updated on 2/12/2009.

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
1	261QP2300X	Clinic/Center	Primary Care	17	ALASKA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	NP1539	MEDICAID	ALASKA
2	MD52881	MEDICAID	ALASKA
3	MD14482	MEDICAID	ALASKA
4	MD3544	MEDICAID	ALASKA

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »