| Northern Neurology, Llc | |
|
3505 E Meridian Park Loop Ste 100 Wasilla AK 99654-7242 | |
| (907) 521-8545 | |
| Not Available |
| Full Name | Northern Neurology, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3505 E Meridian Park Loop Ste 100, Wasilla, Alaska |
| Authorized Official Name and Position | Natasha Ditomaso (PRACTICE MANAGER) |
| Authorized Official Contact | 9075218545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Neurology, Llc 3505 E Meridian Park Loop Ste 100 Wasilla AK 99654-7242 Ph: (907) 521-8545 | Northern Neurology, Llc 3505 E Meridian Park Loop Ste 100 Wasilla AK 99654-7242 Ph: (907) 521-8545 |
| NPI Number | 1306684980 |
|---|---|
| Provider Enumeration Date | 07/17/2024 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Medicare PECOS PAC ID | 6204377435 |
|---|---|
| Medicare Enrollment ID | O20241126002565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306684980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Alison Armour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215390182 PECOS PAC ID: 7012298060 Enrollment ID: I20170105000829 |
| Provider Name | John B Kelly |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407855315 PECOS PAC ID: 3678466570 Enrollment ID: I20231019002342 |
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