| Nurses Diversified Systems, Inc | |
|
815 2nd Ave Ste 122 Fairbanks AK 99701-4469 | |
| (907) 374-0852 | |
| (907) 374-0854 |
| Full Name | Nurses Diversified Systems, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 815 2nd Ave Ste 122, Fairbanks, Alaska |
| Authorized Official Name and Position | Teresa A Lyons (DIRECTOR) |
| Authorized Official Contact | 9077508114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nurses Diversified Systems, Inc Po Box 72376 Fairbanks AK 99707-2376 Ph: (907) 750-8114 | Nurses Diversified Systems, Inc 815 2nd Ave Ste 122 Fairbanks AK 99701-4469 Ph: (907) 374-0852 |
| NPI Number | 1972873784 |
|---|---|
| Provider Enumeration Date | 01/10/2012 |
| Last Update Date | 08/16/2021 |
| Certification Date | 08/16/2021 |
| Medicare PECOS PAC ID | 7517127996 |
|---|---|
| Medicare Enrollment ID | O20120321000698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972873784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 1249 (Alaska) | Primary |
| Provider Name | Teresa Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043524218 PECOS PAC ID: 8820260847 Enrollment ID: I20111017000168 |
| Provider Name | Sharon Geraghty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881239259 PECOS PAC ID: 0749685329 Enrollment ID: I20210819001925 |
| Provider Name | Vanessa Gail Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831826015 PECOS PAC ID: 0840660452 Enrollment ID: I20221222002167 |
| Provider Name | Anna Charlene Cowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255037404 PECOS PAC ID: 2860867702 Enrollment ID: I20230407000296 |
| Provider Name | Danah Elizabeth Angelo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548576390 PECOS PAC ID: 3476918095 Enrollment ID: I20230503001244 |
| Provider Name | Jessica M Mcgrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255609459 PECOS PAC ID: 1153647938 Enrollment ID: I20240125003889 |
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