EAGLE RIVER BEHAVIORAL HEALTH, LLC (NPI# 1366062903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366062903 |
| Entity Type | Organization |
| Organization Name | EAGLE RIVER BEHAVIORAL HEALTH, LLC |
| Practice Address |
13125 Curry Ridge Cir Eagle River AK 99577-6730 |
| Practice Telephone | 9072907033 |
| Mailing Telephone | 9072907033 |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |
| Authorized Official Name | ZAN WHITMAN (PROVIDER) |
| Authorized Official Telephone | 9072907033 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 240808 | 05 |
| Street Address |
13125 CURRY RIDGE CIR |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-6730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154768323 | Leska Nicole James | Nurse Practitioner | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2013-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760017123 | Sara Rottman | Nurse Practitioner | 2210 Sentry Dr Apt 14, Anchorage, AK 99507-5353 | 2020-03-05 |
| 1104464460 | David Ampong | Nurse Practitioner | 1577 C St Ste 204, Anchorage, AK 99501-5164 | 2019-12-18 |
| 1316597412 | Jennifer Byers Anp LLC | Nurse Practitioner | 1689 S Knik Goose Bay Rd Ste 700, Wasilla, AK 99654-8088 | 2019-09-19 |
| 1538720404 | Deanna Mae Casiano | Nurse Practitioner | 14460 E Pace Dr, Palmer, AK 99645-9964 | 2019-06-21 |
| 1154897429 | Kristerra Nicole Yawea | Nurse Practitioner | 2440 E Tudor Rd # 384, Anchorage, AK 99507-1185 | 2018-10-15 |
| 1982187399 | Sara A Lindsoe | Nurse Practitioner | 8136 White Dr, Anchorage, AK 99507-6046 | 2018-09-11 |
| 1245753656 | Richard Crisostomo | Nurse Practitioner | 3505 E Meridian Park Loop Ste 200, Wasilla, AK 99654-7242 | 2017-07-18 |
| 1609326594 | Virginia Walker | Nurse Practitioner | 3211 Providence Drive Rh Ste 116, University of Alaska Anchorage Student Health & Councel, Anchorage, AK 99508 | 2016-10-04 |
| 1922553726 | Adriana Maria Hernandez | Nurse Practitioner | 2405 S Knik Goose Bay Rd, Ste A, Wasilla, AK 99654-9965 | 2016-08-22 |
| 1649622457 | Jenifer Swigart | Nurse Practitioner | 915 W. Northern Lights Blvd, Anchorage, AK 99503 | 2016-07-05 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
Please comment or provide details below to improve the information on EAGLE RIVER BEHAVIORAL HEALTH, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.