| Tanana Valley Clinic LLC | |
|
1001 Noble St Fairbanks AK 99701-4948 | |
| (907) 459-3500 | |
| (907) 459-3526 |
| Full Name | Tanana Valley Clinic LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1001 Noble St, Fairbanks, Alaska |
| Authorized Official Name and Position | Anthony G Sudduth (CFO) |
| Authorized Official Contact | 9074585300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanana Valley Clinic LLC Po Box 73720 Fairbanks AK 99707-3720 Ph: (907) 459-3500 | Tanana Valley Clinic LLC 1001 Noble St Fairbanks AK 99701-4948 Ph: (907) 459-3500 |
| NPI Number | 1922559558 |
|---|---|
| Provider Enumeration Date | 10/19/2016 |
| Last Update Date | 07/15/2025 |
| Certification Date | 07/15/2025 |
| Medicare PECOS PAC ID | 5698056901 |
|---|---|
| Medicare Enrollment ID | O20161228001991 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922559558 | NPI | - | NPPES |
| 1680751 | Medicaid | AK | |
| 1656231 | Medicaid | AK | |
| 1656211 | Medicaid | AK | |
| 1656237 | Medicaid | AK | |
| 1740002 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | () | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | 1043161 (Alaska) | Primary |
| Provider Name | Todd a Capistrant |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1710931613 PECOS PAC ID: 2961301635 Enrollment ID: I20040102000245 |
| Provider Name | Anthony L Blanford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396893749 PECOS PAC ID: 9133118037 Enrollment ID: I20040506001596 |
| Provider Name | Robert W Chalmers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114973708 PECOS PAC ID: 0941287817 Enrollment ID: I20040630000136 |
| Provider Name | Bruce M Footit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760602866 PECOS PAC ID: 2264406271 Enrollment ID: I20040825000406 |
| Provider Name | Michael D Swenson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891761201 PECOS PAC ID: 5698743904 Enrollment ID: I20040923000409 |
| Provider Name | Mark O Simon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043207533 PECOS PAC ID: 3678474491 Enrollment ID: I20050117000563 |
| Provider Name | John T Walters |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215924659 PECOS PAC ID: 2062463391 Enrollment ID: I20050203000867 |
| Provider Name | Heather Powers |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801240221 PECOS PAC ID: 1254382971 Enrollment ID: I20050209000924 |
| Provider Name | Mishelle a Nace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306811559 PECOS PAC ID: 7517905490 Enrollment ID: I20050421000030 |
| Provider Name | Herbert a Day |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609841006 PECOS PAC ID: 2860422235 Enrollment ID: I20050816000291 |
| Provider Name | William W Quirk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306866686 PECOS PAC ID: 6305865262 Enrollment ID: I20051121000399 |
| Provider Name | Michaela R Long |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356446397 PECOS PAC ID: 2668480351 Enrollment ID: I20060322000149 |
| Provider Name | James Timothy Foote |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1033184023 PECOS PAC ID: 4880599869 Enrollment ID: I20060626000324 |
| Provider Name | Jean M Tsigonis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972570604 PECOS PAC ID: 1759286750 Enrollment ID: I20060627000029 |
| Provider Name | Dennis M Rogers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356317762 PECOS PAC ID: 7810909371 Enrollment ID: I20060627000059 |
| Provider Name | Mary Beth Gannett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750356747 PECOS PAC ID: 9335151893 Enrollment ID: I20060627000096 |
| Provider Name | David M Witham |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457328197 PECOS PAC ID: 4082527635 Enrollment ID: I20060627000167 |
| Provider Name | John Breeding |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992748396 PECOS PAC ID: 0042228520 Enrollment ID: I20070724000048 |
| Provider Name | Barbara J Creighton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902943137 PECOS PAC ID: 1254411200 Enrollment ID: I20080103000606 |
| Provider Name | Brian G Accola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447236823 PECOS PAC ID: 5395643878 Enrollment ID: I20080904000705 |
| Provider Name | Zachary R Werle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962524355 PECOS PAC ID: 8527153956 Enrollment ID: I20081015000077 |
| Provider Name | Grayson T Westfall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487847828 PECOS PAC ID: 8426081555 Enrollment ID: I20090723000314 |
| Provider Name | Laura S Brunner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184770778 PECOS PAC ID: 0941354153 Enrollment ID: I20090821000187 |
| Provider Name | Melany Kirschen Grogan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699968891 PECOS PAC ID: 1153516943 Enrollment ID: I20101105000674 |
| Provider Name | Kendrick D Blais |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497771109 PECOS PAC ID: 4880688605 Enrollment ID: I20101201001410 |
| Provider Name | Stephanie a Ranft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851608822 PECOS PAC ID: 6406044080 Enrollment ID: I20101227000032 |
| Provider Name | Brittany B Stepovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174830673 PECOS PAC ID: 5991984965 Enrollment ID: I20110121001030 |
| Provider Name | Peter John Dillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083819460 PECOS PAC ID: 1456532902 Enrollment ID: I20110216001183 |
| Provider Name | Diana L Kovacich |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265631550 PECOS PAC ID: 6204017296 Enrollment ID: I20110302000205 |
| Provider Name | Melissa L Weight |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801123476 PECOS PAC ID: 3678744133 Enrollment ID: I20110914000427 |
| Provider Name | Jed R Weight |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194980680 PECOS PAC ID: 4789856220 Enrollment ID: I20111005000844 |
| Provider Name | Nicole C Bonfoey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639449796 PECOS PAC ID: 5193985844 Enrollment ID: I20120404000576 |
| Provider Name | Romel C Wrenn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255302717 PECOS PAC ID: 6608964358 Enrollment ID: I20120522001048 |
| Provider Name | Jodee L.D. Trivette |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063764504 PECOS PAC ID: 0648422964 Enrollment ID: I20121213000485 |
| Provider Name | Vanessa a Venezia Heuer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851360838 PECOS PAC ID: 9739333709 Enrollment ID: I20130129000609 |
| Provider Name | Wendell O. Eames |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902816820 PECOS PAC ID: 4688618457 Enrollment ID: I20130212000128 |
| Provider Name | Kerry Wappett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982846267 PECOS PAC ID: 1254573108 Enrollment ID: I20130806000671 |
| Provider Name | Joseph Livengood |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518948447 PECOS PAC ID: 4688568181 Enrollment ID: I20130905000268 |
| Provider Name | Dante M Conley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649389503 PECOS PAC ID: 0749424083 Enrollment ID: I20130926000346 |
| Provider Name | Celine M Clift |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598081606 PECOS PAC ID: 3971731902 Enrollment ID: I20140120000303 |
| Provider Name | Christopher B Cowley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104255892 PECOS PAC ID: 1850517723 Enrollment ID: I20140729002908 |
| Provider Name | David S Huntsman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992091953 PECOS PAC ID: 9032331061 Enrollment ID: I20141106002128 |
| Provider Name | Michael John Roylance |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023254935 PECOS PAC ID: 6406904200 Enrollment ID: I20150521001894 |
| Provider Name | Carrie L Conley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942500541 PECOS PAC ID: 3072700640 Enrollment ID: I20150729008813 |
| Provider Name | Richard Sheridan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548425465 PECOS PAC ID: 0941515118 Enrollment ID: I20150817002684 |
| Provider Name | Mindy L Treybal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336389360 PECOS PAC ID: 5698891539 Enrollment ID: I20150930000047 |
| Provider Name | Cynthia Dennis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477765899 PECOS PAC ID: 6507174836 Enrollment ID: I20151006000934 |
| Provider Name | Claire M Stoltz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780948026 PECOS PAC ID: 3274786587 Enrollment ID: I20151103001380 |
| Provider Name | Gary I Molk |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629233895 PECOS PAC ID: 1557553310 Enrollment ID: I20160816001944 |
| Provider Name | Anne R Hanley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841556602 PECOS PAC ID: 7012134661 Enrollment ID: I20161026002244 |
| Provider Name | Ashley Lundgren Strum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467795146 PECOS PAC ID: 9234434275 Enrollment ID: I20161026002673 |
| Provider Name | Owen W Hanley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164789442 PECOS PAC ID: 5092959627 Enrollment ID: I20161101001143 |
| Provider Name | Mary J Johnston |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1649618059 PECOS PAC ID: 9234417882 Enrollment ID: I20161102000353 |
| Provider Name | Muhammad K Ahmed |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1457316051 PECOS PAC ID: 6406836642 Enrollment ID: I20161115000540 |
| Provider Name | Robert O'connor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710103270 PECOS PAC ID: 8123126984 Enrollment ID: I20161123000894 |
| Provider Name | Nicholas P Cosentino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013276898 PECOS PAC ID: 1456675099 Enrollment ID: I20170419001752 |
| Provider Name | Summer S Engler Jager |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1871852319 PECOS PAC ID: 5799921896 Enrollment ID: I20170710003019 |
| Provider Name | Daniel Curns |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215344916 PECOS PAC ID: 0941571798 Enrollment ID: I20170811002945 |
| Provider Name | Stewart M Kerr |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932157732 PECOS PAC ID: 8921271560 Enrollment ID: I20180123000749 |
| Provider Name | Robert Foster Greenwood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356638068 PECOS PAC ID: 1456652601 Enrollment ID: I20180417002607 |
| Provider Name | Jacob Trudeau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841737202 PECOS PAC ID: 1759667884 Enrollment ID: I20180501001710 |
| Provider Name | Jennifer Ribar |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1023492642 PECOS PAC ID: 6406101021 Enrollment ID: I20180621001649 |
| Provider Name | Dayna M Daku |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487172011 PECOS PAC ID: 3870839517 Enrollment ID: I20190116003258 |
| Provider Name | Lance Dunlop |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457452674 PECOS PAC ID: 8224165113 Enrollment ID: I20190307001317 |
| Provider Name | Kristin Ann Flowers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356647051 PECOS PAC ID: 1052534864 Enrollment ID: I20190501002650 |
| Provider Name | Sergei Robinson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740672708 PECOS PAC ID: 6002120854 Enrollment ID: I20190614000887 |
| Provider Name | Amber N Figueroa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689768905 PECOS PAC ID: 1254222821 Enrollment ID: I20190717003249 |
| Provider Name | Carla Michelle Cartagena De Jesus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518312453 PECOS PAC ID: 1658662788 Enrollment ID: I20190903001727 |
| Provider Name | Sally Jane Mangum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912351917 PECOS PAC ID: 3476847674 Enrollment ID: I20191003000911 |
| Provider Name | Kathleen Doris Senecal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235561127 PECOS PAC ID: 7113359308 Enrollment ID: I20191108000724 |
| Provider Name | Robert Matthew Monberg |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679548747 PECOS PAC ID: 1254763469 Enrollment ID: I20191108001544 |
| Provider Name | Julia Franklin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225486228 PECOS PAC ID: 5092147975 Enrollment ID: I20191114001084 |
| Provider Name | Jennifer a Holt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801054879 PECOS PAC ID: 9931274206 Enrollment ID: I20191213002129 |
| Provider Name | Androcles Lester |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154740157 PECOS PAC ID: 0446470157 Enrollment ID: I20200225001940 |
| Provider Name | Sandra Speerstra |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427539345 PECOS PAC ID: 0042646721 Enrollment ID: I20200307000177 |
| Provider Name | Gwendolyn Lieb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750709978 PECOS PAC ID: 0648583690 Enrollment ID: I20200326003373 |
| Provider Name | Jessie Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528321643 PECOS PAC ID: 0648589804 Enrollment ID: I20200526001988 |
| Provider Name | Jayme Schroeder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215466081 PECOS PAC ID: 0345679882 Enrollment ID: I20200818002441 |
| Provider Name | Daniel Rohlf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396127098 PECOS PAC ID: 2769794676 Enrollment ID: I20200924001551 |
| Provider Name | Amy Vagedes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699193318 PECOS PAC ID: 3476855982 Enrollment ID: I20201016000888 |
| Provider Name | Jennifer Lucey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811248073 PECOS PAC ID: 3678725330 Enrollment ID: I20201125001436 |
| Provider Name | Stephanie Willet |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023375292 PECOS PAC ID: 6709151699 Enrollment ID: I20201208001641 |
| Provider Name | Allan L Long |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770533317 PECOS PAC ID: 3274945456 Enrollment ID: I20201211000692 |
| Provider Name | Gisella P Puga |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417285032 PECOS PAC ID: 9830234707 Enrollment ID: I20210105002610 |
| Provider Name | Anthony Bonitatibus |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1689606477 PECOS PAC ID: 1456255124 Enrollment ID: I20210126000836 |
| Provider Name | Kyle D Aemisegger |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740488741 PECOS PAC ID: 6305003500 Enrollment ID: I20210209002448 |
| Provider Name | Eric T Fiedler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437516903 PECOS PAC ID: 3577817907 Enrollment ID: I20210428002240 |
| Provider Name | Shannon L Dieffenderfer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861048530 PECOS PAC ID: 9032526272 Enrollment ID: I20210505003147 |
| Provider Name | Stephen Odegard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710335740 PECOS PAC ID: 7911290713 Enrollment ID: I20210517001843 |
| Provider Name | Michelle R Floyd |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245327576 PECOS PAC ID: 1355343039 Enrollment ID: I20210903001921 |
| Provider Name | Mary Beth Risvold |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346322559 PECOS PAC ID: 0244271146 Enrollment ID: I20210914000570 |
| Provider Name | Lauren Doerfler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861854093 PECOS PAC ID: 0345507513 Enrollment ID: I20211005002512 |
| Provider Name | Margaret C Quirion |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083190474 PECOS PAC ID: 1658615745 Enrollment ID: I20211021000922 |
| Provider Name | Lori Dionne Conklin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659350122 PECOS PAC ID: 1052394897 Enrollment ID: I20211021002229 |
| Provider Name | Karyn Marie Nunez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184966871 PECOS PAC ID: 6901031061 Enrollment ID: I20220105002270 |
| Provider Name | Tyson Rutledge |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740564400 PECOS PAC ID: 6406021179 Enrollment ID: I20220322001262 |
| Provider Name | Lisa Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417697780 PECOS PAC ID: 8426436478 Enrollment ID: I20220602001453 |
| Provider Name | Keegan Mcafee |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427554740 PECOS PAC ID: 5092062067 Enrollment ID: I20220720003522 |
| Provider Name | Katherine Clawson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003554056 PECOS PAC ID: 7618352741 Enrollment ID: I20220909002467 |
| Provider Name | Sriharsha Gowtham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043747587 PECOS PAC ID: 1052657657 Enrollment ID: I20220913003719 |
| Provider Name | Brynn E Ehlers Jaschen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649763129 PECOS PAC ID: 8921408576 Enrollment ID: I20220915003549 |
| Provider Name | Savannah C Cahill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003442294 PECOS PAC ID: 8224413950 Enrollment ID: I20220916001448 |
| Provider Name | Stephanie Lois Leong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033190822 PECOS PAC ID: 2466829080 Enrollment ID: I20221110000720 |
| Provider Name | Jeri Rosenbloom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134844749 PECOS PAC ID: 4183092695 Enrollment ID: I20221114003033 |
| Provider Name | Shane Richard Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063137677 PECOS PAC ID: 3870962574 Enrollment ID: I20221219001645 |
| Provider Name | Ian K Brimhall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467652875 PECOS PAC ID: 5799858452 Enrollment ID: I20221219002894 |
| Provider Name | Victoria a Buckmeier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609545532 PECOS PAC ID: 8022488758 Enrollment ID: I20221221001333 |
| Provider Name | Vanessa Gail Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831826015 PECOS PAC ID: 0840660452 Enrollment ID: I20221222002167 |
| Provider Name | Neil Hurd |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487703997 PECOS PAC ID: 1850484429 Enrollment ID: I20230120002068 |
| Provider Name | Vuth-channy Chhor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295352706 PECOS PAC ID: 5092139824 Enrollment ID: I20230224002070 |
| Provider Name | Ariana Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992410237 PECOS PAC ID: 1254706195 Enrollment ID: I20230407000564 |
| Provider Name | Megan Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205227097 PECOS PAC ID: 5597084509 Enrollment ID: I20230526002418 |
| Provider Name | Christine N Frost |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932805397 PECOS PAC ID: 8426416447 Enrollment ID: I20230623001962 |
| Provider Name | Mariah Ann Minder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902369077 PECOS PAC ID: 0840654893 Enrollment ID: I20230911001174 |
| Provider Name | Stefanie a Lai |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1518429083 PECOS PAC ID: 3870917321 Enrollment ID: I20231006002337 |
| Provider Name | Ashley Ellsworth Call |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255575056 PECOS PAC ID: 0042665143 Enrollment ID: I20231010001669 |
| Provider Name | Heather May Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205619772 PECOS PAC ID: 9638525868 Enrollment ID: I20231025000436 |
| Provider Name | Tiffany Borbon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760019665 PECOS PAC ID: 3577986058 Enrollment ID: I20231109000117 |
| Provider Name | Stefan Leo-nyquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114414265 PECOS PAC ID: 3971852377 Enrollment ID: I20231109000642 |
| Provider Name | James Vodvarka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518955210 PECOS PAC ID: 9335191600 Enrollment ID: I20231120000912 |
| Provider Name | Michael Aaron Parente |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699553545 PECOS PAC ID: 9032568209 Enrollment ID: I20231213001761 |
| Provider Name | Brenda Susan Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407630734 PECOS PAC ID: 6002266780 Enrollment ID: I20231220003834 |
| Provider Name | Jaime Nicole Ringstad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942862149 PECOS PAC ID: 2860835915 Enrollment ID: I20240206003049 |
| Provider Name | Cindy D Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164299178 PECOS PAC ID: 4385087816 Enrollment ID: I20240212002093 |
| Provider Name | Kari D Velzke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285401075 PECOS PAC ID: 1557709086 Enrollment ID: I20240403002456 |
| Provider Name | Alyssa T Prollock |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1215614409 PECOS PAC ID: 4981044088 Enrollment ID: I20240506001390 |
| Provider Name | Stephen Kujansuu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295925477 PECOS PAC ID: 1850520990 Enrollment ID: I20240618002772 |
| Provider Name | Peter K Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205943511 PECOS PAC ID: 7517141310 Enrollment ID: I20240619000678 |
| Provider Name | Aaron Sabey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992824130 PECOS PAC ID: 0143540393 Enrollment ID: I20240626001656 |
| Provider Name | Sarah K Fatool |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821582313 PECOS PAC ID: 1456600170 Enrollment ID: I20240821004221 |
| Provider Name | Sara Haack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164798203 PECOS PAC ID: 5496077380 Enrollment ID: I20240908000023 |
| Provider Name | Naomi Pomerantz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912589144 PECOS PAC ID: 4284036229 Enrollment ID: I20240930003006 |
| Provider Name | Roger Ivey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801976949 PECOS PAC ID: 5991737256 Enrollment ID: I20241018000446 |
| Provider Name | Abraham Tsigonis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881986115 PECOS PAC ID: 7012145022 Enrollment ID: I20241126004328 |
| Provider Name | Joshua Wolf |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649274333 PECOS PAC ID: 0244126407 Enrollment ID: I20241127001536 |
| Provider Name | Linda Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538176813 PECOS PAC ID: 8325024854 Enrollment ID: I20241202000629 |
| Provider Name | Helen Gaynes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295515542 PECOS PAC ID: 2567810047 Enrollment ID: I20241203001313 |
| Provider Name | Kelsey Thompson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336770544 PECOS PAC ID: 6507266590 Enrollment ID: I20241204004056 |
| Provider Name | Janet Gill |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467476283 PECOS PAC ID: 1456353416 Enrollment ID: I20241212002015 |
| Provider Name | Ciara Lynn Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548844129 PECOS PAC ID: 4880121060 Enrollment ID: I20241230002456 |
| Provider Name | James Lafleur |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285106096 PECOS PAC ID: 1557601770 Enrollment ID: I20250129002897 |
| Provider Name | Geraldine Tookey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215922901 PECOS PAC ID: 8628245677 Enrollment ID: I20250130000331 |
| Provider Name | Douglas Katein-taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881084101 PECOS PAC ID: 2860707585 Enrollment ID: I20250210003125 |
| Provider Name | Nettie Olivia Larson Irwin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801475314 PECOS PAC ID: 9739563685 Enrollment ID: I20250211001341 |
| Provider Name | Elizabeth Ricca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255640967 PECOS PAC ID: 0547617532 Enrollment ID: I20250213002814 |
| Provider Name | Shannon Smith |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1043673791 PECOS PAC ID: 6204170004 Enrollment ID: I20250213003545 |
| Provider Name | Anne Gray |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093876674 PECOS PAC ID: 1052683703 Enrollment ID: I20250224002304 |
| Provider Name | Robert P Barnard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992066260 PECOS PAC ID: 4183145428 Enrollment ID: I20250304000716 |
| Provider Name | Rashna Ginwalla |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093962284 PECOS PAC ID: 9638294416 Enrollment ID: I20250305003190 |
| Provider Name | David Baker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033356217 PECOS PAC ID: 8426105008 Enrollment ID: I20250409002350 |
| Provider Name | Stephen Ake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659657948 PECOS PAC ID: 0749581189 Enrollment ID: I20250410002686 |
| Provider Name | Timothy James Zerhusen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841825080 PECOS PAC ID: 2860917085 Enrollment ID: I20250421002365 |
| Provider Name | Porsche Dehut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487459327 PECOS PAC ID: 3971028911 Enrollment ID: I20250422003083 |
| Provider Name | Erin Murphy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407634470 PECOS PAC ID: 0042757890 Enrollment ID: I20250423003119 |
| Provider Name | Wendell Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063069466 PECOS PAC ID: 6204261654 Enrollment ID: I20250502001632 |
| Provider Name | Emery J Chang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639261654 PECOS PAC ID: 9335133412 Enrollment ID: I20250502002254 |
| Provider Name | Gregory Burchett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194989269 PECOS PAC ID: 0244398105 Enrollment ID: I20250508000634 |
| Provider Name | Jane Dimer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558419093 PECOS PAC ID: 8325294937 Enrollment ID: I20250514003763 |
| Provider Name | Kathryn Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568065894 PECOS PAC ID: 5092128108 Enrollment ID: I20250530001880 |
| Provider Name | Laura Lane |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497737217 PECOS PAC ID: 1254511504 Enrollment ID: I20250603000335 |
| Provider Name | Kimberly Frazier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013953678 PECOS PAC ID: 7517918154 Enrollment ID: I20250612002137 |
| Provider Name | Theresa Konieczny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720615958 PECOS PAC ID: 8628485554 Enrollment ID: I20250612003392 |
| Provider Name | Bovey Jingzhu Wu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033851175 PECOS PAC ID: 9739690967 Enrollment ID: I20250616001616 |
| Provider Name | Raymond J Broadbent |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609892850 PECOS PAC ID: 4183670805 Enrollment ID: I20250618000201 |
| Provider Name | Deven Anthony Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962812164 PECOS PAC ID: 2668986209 Enrollment ID: I20250708000160 |
| Provider Name | Tristan David Glenn |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1437882099 PECOS PAC ID: 1456865567 Enrollment ID: I20250710000729 |
| Provider Name | Nathan Marsh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710030044 PECOS PAC ID: 6901113182 Enrollment ID: I20250710001021 |
| Provider Name | David R Lebec |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871569491 PECOS PAC ID: 7810962818 Enrollment ID: I20250714003140 |
| Provider Name | Alexander Merritt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861132920 PECOS PAC ID: 9638550692 Enrollment ID: I20250714003990 |
| Provider Name | Lindsay Carolyn Clough |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598227894 PECOS PAC ID: 6406361450 Enrollment ID: I20250717001462 |
| Provider Name | Jeffery Chen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962470138 PECOS PAC ID: 2466448360 Enrollment ID: I20250728000656 |
| Provider Name | Allyson Jones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720662463 PECOS PAC ID: 1355859075 Enrollment ID: I20250804003551 |
| Provider Name | Kristopher Matelic |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407243835 PECOS PAC ID: 2163735788 Enrollment ID: I20250807002088 |
| Provider Name | Nathan J Kessler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033612874 PECOS PAC ID: 3577989524 Enrollment ID: I20250820001311 |
| Provider Name | Kelsey R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235926007 PECOS PAC ID: 8921508664 Enrollment ID: I20250826002238 |
| Provider Name | Jeanne Debono |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447258512 PECOS PAC ID: 3072673631 Enrollment ID: I20251024003754 |
| Provider Name | David Summers Wichmann |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295272417 PECOS PAC ID: 1254822281 Enrollment ID: I20251118000320 |
| Provider Name | James Alexander Jordan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396368197 PECOS PAC ID: 2961998729 Enrollment ID: I20251231001169 |
| Provider Name | Shannon Agne |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255203394 PECOS PAC ID: 5597251025 Enrollment ID: I20260105000988 |
| Provider Name | Mitchell Andreas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205301421 PECOS PAC ID: 4587031810 Enrollment ID: I20260115002442 |
| Provider Name | Rebekah Ann Capen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861359143 PECOS PAC ID: 8729566146 Enrollment ID: I20260128001462 |
| Provider Name | Dexter Allen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437711256 PECOS PAC ID: 5193205672 Enrollment ID: I20260213003132 |
| Provider Name | Cassie Lafferty |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285274142 PECOS PAC ID: 3870967771 Enrollment ID: I20260317003209 |
| Provider Name | Eric Matthew Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942154265 PECOS PAC ID: 0840765137 Enrollment ID: I20260403002612 |
| Provider Name | David Hickling |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1245645282 PECOS PAC ID: 5991025454 Enrollment ID: I20260420003422 |
| Provider Name | Justine Blaud |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1770012403 PECOS PAC ID: 0749659498 Enrollment ID: I20260506001324 |
| Provider Name | Azucena Gault |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487977724 PECOS PAC ID: 9234265356 Enrollment ID: I20260529001152 |
Fbx Fairbanks Behavior Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3245 Craft Ave, Fairbanks, AK 99709 Phone: 907-378-3434 Fax: 907-374-0820 |
Pacific Rim Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 Barnette St Ste 102, Fairbanks, AK 99701 Phone: 907-452-5252 Fax: 907-452-6233 |
Fairbanks Somatic Therapy and Wellness LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Cushman St Ste 4e, Fairbanks, AK 99701 Phone: 907-371-5359 |
Cura One Care PLLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3550 Airport Way Ste 4, Fairbanks, AK 99709 Phone: 907-313-6084 Fax: 505-805-7356 |
Fairbanks Community Behavioral Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3830 S Cushman St, Fairbanks, AK 99701 Phone: 907-452-1575 Fax: 907-455-5287 |
Making a Difference Support Services, LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1867 Airport Way Ste 200, Fairbanks, AK 99701 Phone: 907-750-7169 Fax: 907-490-4469 |