Provider Demographics
NPI:1174537674
Name:CROSS, NANCY E (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:CROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1275 SADLER WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3171
Mailing Address - Country:US
Mailing Address - Phone:907-374-6602
Mailing Address - Fax:907-374-6604
Practice Address - Street 1:1275 SADLER WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3171
Practice Address - Country:US
Practice Address - Phone:907-374-6602
Practice Address - Fax:907-374-6604
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKAK5184207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD58281Medicaid
AK152681Medicare ID - Type Unspecified
AKMD58281Medicaid