Provider Demographics
NPI:1083203574
Name:TURCOTTE, MELINDA LEE (APRN)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:LEE
Last Name:TURCOTTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 OLD RICHARDSON HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-7805
Mailing Address - Country:US
Mailing Address - Phone:907-328-0844
Mailing Address - Fax:
Practice Address - Street 1:751 OLD RICHARDSON HWY STE 203
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7805
Practice Address - Country:US
Practice Address - Phone:907-328-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURR26215163W00000X
AK175347363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse