SHELLEY WANTAJA (NPI# 1417585902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417585902 |
Entity Type | Individual |
Full Name | SHELLEY WANTAJA |
Credential | APRN, FNP-C |
Practice Address |
689 E Eklutna St Palmer AK 99645-6116 |
Practice Telephone | 9078412531 |
Mailing Telephone | 9078412531 |
Enumeration Date | 2020-03-30 |
Last Update Date | 2020-03-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
158314 | AK | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
689 E EKLUTNA ST |
City | PALMER |
State | AK |
Zip Code | 99645-6116 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
Find all providers in zip 99645 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730350315 | Deborah Joan Till | Nurse Practitioner | 250 E Fireweed Ave, Alaska Veterans and Pioneer Home, Palmer, AK 99645-6638 | 2008-03-21 |
1437374600 | Mary Alison Barrett | Nurse Practitioner | 440a W Evergreen Ave, Palmer, AK 99645-6955 | 2007-04-14 |
1427062470 | Tracy Lee Michalski | Nurse Practitioner | 2490 S Woodworth Loop Ste 250, Palmer, AK 99645 | 2006-07-27 |
1376524967 | Caryn Sue Gonzales | Nurse Practitioner | 16720 E Maud Rd, Palmer, AK 99645-7520 | 2005-11-10 |
1578101234 | Todd Baer | Nurse Practitioner | 780 S Snodgrass Dr, Palmer, AK 99645-9149 | 2019-12-12 |
1548725559 | Malia Weber-parker | Nurse Practitioner | 1001 Thorndike St, Palmer, MA 01069-1501 | 2019-02-04 |
1285146498 | Mary Charlotte Guertin | Nurse Practitioner | 40 Wright St, Palmer, MA 01069-1138 | 2017-10-27 |
1891204475 | Lea A Grippin | Nurse Practitioner | 40 Wright St, Palmer, MA 01069-1138 | 2017-09-26 |
1669922506 | Danielle Suzanne Hawkins | Nurse Practitioner | 625 S Cobb St, Ste 201, Palmer, AK 99645-6480 | 2016-10-04 |
1932552858 | Michael Joseph Fine | Nurse Practitioner | 40 Wright St, Palmer, MA 01069-1138 | 2016-07-15 |
Find all providers in PALMER |
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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.