Provider Demographics
NPI:1225045727
Name:HEWITT, ANNETTE M (ANP)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:HEWITT
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 1:4358 RENDEZVOUS CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4219
Mailing Address - Country:US
Mailing Address - Phone:907-338-2086
Mailing Address - Fax:
Practice Address - Street 1:2841 DEBARR RD
Practice Address - Street 2:SUITE 40
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2932
Practice Address - Country:US
Practice Address - Phone:907-743-1435
Practice Address - Fax:907-743-1400
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK494363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNPO4941Medicaid
AKNPO4941Medicaid
AKMHO392023OtherDEA
S47181Medicare UPIN
AKNPO4941Medicaid