LISA MARIE MCENULTY


Address: 1027 Evergreen St, Fairbanks, AK 99709-4306
Phone: 9074518164

LISA MARIE MCENULTY (NPI# 1619523438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619523438
Entity Type Individual
Full Name LISA MARIE MCENULTY
Credential AAS
Practice Address 1027 Evergreen St
Fairbanks
AK 99709-4306
Mailing Address 1041 Kellum St Apt D305
Fairbanks
AK 99701-4396
Practice Telephone 9074518164
Practice Fax Number 9074510273
Mailing Telephone 9076877966
Enumeration Date 2019-08-16
Last Update Date 2019-08-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 174400000X Specialist Other Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
3100 S Cushman St, Fairbanks, AK 997017516 9074526251 9074564849

Office Location

Street Address 1027 EVERGREEN ST
City FAIRBANKS
State AK
Zip Code 99709-4306

Providers in the same location

NPI Name Taxonomy Address Enumeration
1669681599 Jimmy Spears Substance Abuse Rehabilitation Facility 1027 Evergreen St, Fairbanks, AK 99709-4306 2007-05-21
1639794845 Amee Mchatten Counselor 1027 Evergreen St, Fairbanks, AK 99709-4306 2020-06-12
1588207401 Katina Beth Sammons Counselor 1027 Evergreen St, Fairbanks, AK 99709-4306 2019-10-23
1700433562 Rebecka Snider Registered Nurse 1027 Evergreen St, Fairbanks, AK 99709-4306 2019-08-26
1033765375 Brian Keith Pickett Jr. Case Manager/Care Coordinator 1027 Evergreen St, Fairbanks, AK 99709-4306 2019-08-13
1538714571 Brandi Krueger Counselor 1027 Evergreen St, Fairbanks, AK 99709-4306 2019-08-06
1225587918 Brian Hughes Counselor 1027 Evergreen St, Fairbanks, AK 99709 2016-09-23
1528331691 Alison D Holleman Case Manager/Care Coordinator 1027 Evergreen St, Fairbanks, AK 99709-4306 2012-02-20
1558507111 Jessica R Hedge Counselor 1027 Evergreen St, Fairbanks, AK 99709-4306 2008-12-31
1215187505 Kathleen Ketzler Demientieff Counselor 1027 Evergreen St, Fairbanks, AK 99709-4306 2008-09-24
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255946810 Beacon Monitoring Professional Services Technician, Other 745 Staffordshire Rd, Fairbanks, AK 99709 2020-09-10
1235629544 Fairbanks Healing Space Health Educator 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 2018-05-11
1609395409 Shawn K Goggins Counselor 1423 Peger Road, Fairbanks, AK 99709 2017-09-12
1710433347 Jay Titus Technician/Technologist 2884 Marina Drive, Fairbanks, AK 99709 2016-09-01
1710391610 Hannah Summerfelt Dentist 3539 Thomas St, Fairbanks, AK 99709 2014-06-18
1629407325 Diane Louise Mitchell Nurse Practitioner 4650 Harvard Cir, Fairbanks, AK 99709 2013-11-04
1407147929 Christina Martz Counselor 1270 Summet Drive, Fairbanks, AK 99709 2011-05-02
1255652285 Surgery Center of Fairbanks LLC Clinic/Center 2310 Peger Road, Fairbanks, AK 99709 2010-06-14
1962661835 John Leo Hughes Jr Jr. Dentist 3437 Airport Way, Suite 205, Fairbanks, AL 99709 2008-06-05
1508042417 Katherine E Johnson, Md PC Ophthalmology 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 2008-01-10
Find all providers in zip 99709

Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114378031 Thomas Walton Specialist 505 Illinois St Ste 4, Fairbanks, AK 99701-2946 2016-06-22
1386815678 Interior Alaska Orthopedic & Sports Medicine Inc Specialist 2310 Peger Rd Ste 105, Fairbanks, AK 99709-5305 2008-03-14
1780875617 Victoria L Ketchum Specialist E. Cowles, Fairbanks Memorial Hospital, Fairbanks, AK 99702 2007-08-06
1851596290 Healthy Connections Specialist 530 7th Ave Ste 3, Fairbanks, AK 99701-4971 2007-06-16
1417159864 William Robert Packee Specialist 709 Baffin Court, Fairbanks, AK 99701 2007-06-05
1396813762 Jawana Jean Cox Specialist 654 Wagner Ln, Fairbanks, AK 99712-2827 2006-12-01
1609981265 John W. Joosse Specialist 1411 19th Ave, Fairbanks, AK 99701-5902 2006-08-21
1649384744 Kathie Lorraine Felker Specialist 515 7th Ave, Suite 130, Fairbanks, AK 99701-4933 2006-08-18
1548814460 Heidi Rosabelle Webb Specialist 3101 Lathrop St, Fairbanks, AK 99701-7426 2019-07-29
1801449467 Danere Denise Hanna Specialist 1825 Marika Rd, Fairbanks, AK 99709-5521 2019-07-22
Find all providers in FAIRBANKS

Competitor

Search similar providers

City FAIRBANKS
Zip Code 99709

Improve Information

Please comment or provide details below to improve the information on LISA MARIE MCENULTY.

Dataset Information

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.

Trending Searches