Provider Demographics
NPI:1750114922
Name:POWELL, WHITNEY PAIGE (FNP-C)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:PAIGE
Last Name:POWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 BRANDYWINE AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-3112
Mailing Address - Country:US
Mailing Address - Phone:907-229-1186
Mailing Address - Fax:
Practice Address - Street 1:2920 BRANDYWINE AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-3112
Practice Address - Country:US
Practice Address - Phone:907-229-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK227059363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty