GLACIER PEDIATRICS LLC NPI 1558500694

NPI Information

  • NPI: 1558500694
  • Provider Name: GLACIER PEDIATRICS, LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 02D0641335
  • Address: 1600 GLACIER AVE
    JUNEAU, AK
    ZIP 99801
  • Phone: (907) 586-1542

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NPI Details

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
1261QP2300XClinic/CenterPrimary Care17ALASKAYes

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 Other Provider Identifier Issuer
1NP1539MEDICAIDALASKA
2MD52881MEDICAIDALASKA
3MD14482MEDICAIDALASKA
4MD3544MEDICAIDALASKA

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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