Provider Demographics
NPI: | 1114933876 |
---|---|
Name: | CHRISTIANS, LAUREL ANNE (ANP) |
Entity type: | Individual |
Prefix: | |
First Name: | LAUREL |
Middle Name: | ANNE |
Last Name: | CHRISTIANS |
Suffix: | |
Gender: | F |
Credentials: | ANP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 4320 DIPLOMACY DR |
Mailing Address - Street 2: | |
Mailing Address - City: | ANCHORAGE |
Mailing Address - State: | AK |
Mailing Address - Zip Code: | 99508-5925 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 907-563-2662 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4320 DIPLOMACY DR |
Practice Address - Street 2: | |
Practice Address - City: | ANCHORAGE |
Practice Address - State: | AK |
Practice Address - Zip Code: | 99508-5925 |
Practice Address - Country: | US |
Practice Address - Phone: | 907-563-2662 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-01 |
Last Update Date: | 2025-04-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MT | NUR-APRN-LIC-178758 | 363LF0000X |
AK | 838 | 163W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No | 163W00000X | Nursing Service Providers | Registered Nurse |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AK | NP40621 | Medicaid | |
AK | Q23493 | Medicare UPIN | |
AK | 8EC382 | Medicare ID - Type Unspecified |