Provider Demographics
NPI:1073846333
Name:HALSEY, AMBER
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:
Last Name:HALSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 BARROW ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3631
Mailing Address - Country:US
Mailing Address - Phone:907-258-3498
Mailing Address - Fax:907-279-0171
Practice Address - Street 1:357 E PARKS HWY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7040
Practice Address - Country:US
Practice Address - Phone:907-357-5627
Practice Address - Fax:907-357-5628
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCMPENDINGMedicaid