Provider Demographics
NPI:1093821415
Name:MERCIER, LEEANNE K (ANP)
Entity Type:Individual
Prefix:
First Name:LEEANNE
Middle Name:K
Last Name:MERCIER
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 1:4200 LAKE OTIS PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5226
Mailing Address - Country:US
Mailing Address - Phone:907-929-9586
Mailing Address - Fax:907-929-3836
Practice Address - Street 1:4200 LAKE OTIS PKWY STE 105
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5226
Practice Address - Country:US
Practice Address - Phone:907-929-9586
Practice Address - Fax:907-929-3836
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK235363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP18893Medicaid