WALTER TANNER (NPI# 1063011005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063011005 |
| Entity Type | Individual |
| Full Name | WALTER TANNER |
| Practice Address |
436 5th Avenue Kotzebue AK 99752 |
| Mailing Address |
235 Gossom Switch Rd Wetumpka AL 36092-8578 |
| Practice Telephone | 9077294898 |
| Practice Fax Number | 9077291542 |
| Mailing Telephone | 3344521250 |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
159065 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
436 5TH AVENUE |
| City | KOTZEBUE |
| State | AK |
| Zip Code | 99752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295795342 | Linda Olson Bergum | Family Medicine | 436 5th Avenue, Kotzebue, AK 99752 | 2006-03-24 |
| 1811490139 | Magdeline L Booth | Prevention Professional | 436 5th Avenue, Kotzebue, AK 99752 | 2018-03-13 |
| 1710490701 | Denzel Mann | Pharmacist | 436 5th Avenue, Maniilaq Health Center, Kotzebue, AK 99752-9975 | 2017-11-13 |
| 1275089997 | Meagan Lincoln | Optometrist | 436 5th Avenue, Kotzebue, AK 99752 | 2016-09-01 |
| 1932486123 | Lisa C Shindler | Physician Assistant | 436 5th Avenue, Kotzebue, AK 99752 | 2011-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770103731 | Breanna Rosales | Counselor | 433 5 Th Ave, Kotzebue, AK 99752 | 2020-04-20 |
| 1679118814 | Verna Mariam Sherman | Case Manager/Care Coordinator | 733 2nd Ave., Kotzebue, AK 99752 | 2019-11-12 |
| 1568979565 | John Steven Ferraro | Counselor | 733 2'nd Ave, Kotzebue, AK 99752 | 2017-12-29 |
| 1528585494 | Guardian Flight LLC | Ambulance | Teacher Housing Apt # 18 Lagoon Street, Kotzebue, AK 99752 | 2017-08-23 |
| 1366998114 | Alaskans Changing Together, Inc. | Counselor | 241 5th Ave, Kotzebue, AK 99752 | 2016-08-31 |
| 1205236692 | Kimberly Baldwin | Dental Therapist | 436 5th Ave Ted Stevens Way, Kotzebue, AK 99752 | 2014-09-04 |
| 1811309040 | Sylvia Michelle Windham | Advanced Practice Midwife | 436 5th Avenue and Ted Stevens Way, Kotzebue, AK 99752 | 2014-05-22 |
| 1881941193 | Belynda M. Gregg | Case Manager/Care Coordinator | 256 2nd Ave, F.r. Ferguson Building, Kotzebue, AK 99752 | 2012-08-07 |
| 1689932436 | Srikanth Rao Dakoji | Family Medicine | 479 Mission St, Apt C8, Kotzebue, AK 99752 | 2012-04-30 |
| 1932434792 | Joseph E Copeland | Family Medicine | Maniilaq Healh Center, Box 43, Kotzebue, AK 99752 | 2009-10-13 |
| Find all providers in zip 99752 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285156448 | Michael Dwayne Steward | Nurse Practitioner | 436 5th Ave, Kotzebue, AK 99752 | 2017-07-10 |
| 1801040811 | Kristen M Hammer | Nurse Practitioner | 436 5th and Ted Stevens Way, Kotzebue, AK 99752 | 2008-11-05 |
| 1811906423 | Melissa Catherine Statham | Nurse Practitioner | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355390 | Delia M. Reyes | Nurse Practitioner | 705 2nd St., Cordova, AK 99574 | 2020-10-29 |
| 1396342895 | Stacey Reynolds Dahl | Nurse Practitioner | 103 Fram Treet, Petersburg, AK 99833-0589 | 2020-10-07 |
| 1912514647 | Kaveri Bharti | Nurse Practitioner | 2900 Morgan Loop, Anchorage, AK 99516-1427 | 2020-09-27 |
| 1831709070 | China Kay Larson | Nurse Practitioner | 9402 Endicott St, Anchorage, AK 99502-1342 | 2020-08-03 |
| 1144847021 | Stephanie Anne Olah Packard | Nurse Practitioner | 6929 Crawford St, Anchorage, AK 99502-2728 | 2020-06-26 |
| 1134743370 | Matthew G Horgan | Nurse Practitioner | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0827 | 2020-06-03 |
| 1417585902 | Shelley Wantaja | Nurse Practitioner | 689 E Eklutna St, Palmer, AK 99645-6116 | 2020-03-30 |
| 1437787363 | Naomi Tonje Johnson | Nurse Practitioner | 5428 E Rebecca Nicole St Unit C, Wasilla, AK 99654-0002 | 2020-03-27 |
| 1235789322 | Halley Marie Fondren | Nurse Practitioner | Page Street, Soldotna, AK 99669-2634 | 2019-09-19 |
| 1710535380 | Peter Harvey | Nurse Practitioner | 755 Knightsbridge Rd, Fairbanks, AK 99709-2477 | 2019-08-27 |
| Find all providers with the same taxonomy | ||||
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| 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.