Provider Demographics
NPI:1083638423
Name:KILEY, DEBORAH (ANP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:KILEY
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 1:3310 ARCTIC BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4576
Mailing Address - Country:US
Mailing Address - Phone:907-250-5755
Mailing Address - Fax:907-802-6585
Practice Address - Street 1:3310 ARCTIC BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4576
Practice Address - Country:US
Practice Address - Phone:907-250-5755
Practice Address - Fax:907-802-6585
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP03483Medicaid
S84827Medicare UPIN
AKNP03483Medicaid