NATIVE VILLAGE OF EKLUTNA (NPI# 1891930699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891930699 |
| Entity Type | Organization |
| Organization Name | NATIVE VILLAGE OF EKLUTNA |
| Other Organization Name | EKLUTNA VILLAGE CLINIC |
| Practice Address |
26339 Eklutna Village Rd. Chugiak AK 99567-0666 |
| Mailing Address |
26339 Eklutna Village Rd P.o. Box 670666 Chugiak AK 99567-5148 |
| Practice Telephone | 9076886031 |
| Practice Fax Number | 9076886032 |
| Mailing Telephone | 9076886031 |
| Mailing Fax Number | 9076886032 |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2012-04-05 |
| Authorized Official Name | MRS. VIOLET FRANCES RICE (HEALTH DIRECTOR/PROVIDER) |
| Authorized Official Telephone | 9076886031 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | NP02962 | 05 | |
| AK | CL5246 | 05 |
| Other Name | Type Code |
|---|---|
| Eklutna Village Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NATIVE VILLAGE OF EKLUTNA | 26339 Eklutna Village Rd, Chugiak, AK 99567-5148 |
| Street Address |
26339 EKLUTNA VILLAGE RD. |
| City | CHUGIAK |
| State | AK |
| Zip Code | 99567-0666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326552217 | Lilian Alison Crites-flesher | Massage Therapist | 21944 Rankin Rd, Chugiak, AK 99567 | 2017-11-30 |
| 1457886368 | Deborah Joyce Forcht | Nurse Practitioner | 22525 Ursa Major Circle, Chugiak, AK 99567 | 2017-04-28 |
| 1871976662 | Aurora Advocacy LLC | Case Management | 19991 Tulwar Drive, Chugiak, AK 99567 | 2015-06-30 |
| 1497028526 | Phillip D. Courtney | Contractor | 18708 Sue Tawn Drive, Chugiak, AK 99567 | 2012-02-21 |
| 1265717540 | Aurora Borealis Assisted Living Home LLC | Assisted Living Facility | 22179 North Birchwood Loop, Chugiak, AK 99567 | 2011-10-18 |
| 1114184181 | Cs Wellness, LLC | Chiropractor | 20775 Old Glenn Highway, Chugiak, AK 99567 | 2008-05-19 |
| 1295909588 | Patricia Ann Morgan | Speech-Language Pathologist | 18618 Amonson Road, Chugiak, AK 99567 | 2008-04-17 |
| 1053505917 | Chugiak Volunteer Fire & Rescue Inc | Ambulance | 17214 Old Glenn Hwy, Chugiak, AK 99567 | 2007-09-04 |
| 1902020290 | Lorraine Fullbright | Case Manager/Care Coordinator | 18606 Old Glenn Highway, Chugiak, AK 99567 | 2007-04-11 |
| 1235273343 | Kirby W Holtman | Chiropractor | 20963 Bill Stephens Dr., Chugiak, AK 99567 | 2007-02-20 |
| Find all providers in zip 99567 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457886368 | Deborah Joyce Forcht | Nurse Practitioner | 22525 Ursa Major Circle, Chugiak, AK 99567 | 2017-04-28 |
| 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.