Provider Demographics
NPI:1285649731
Name:OUIMET, NANCY J (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:OUIMET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12110 BUSINESS BLVD
Mailing Address - Street 2:SUITE 6 PMB 376
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7741
Mailing Address - Country:US
Mailing Address - Phone:907-301-9416
Mailing Address - Fax:
Practice Address - Street 1:12110 BUSINESS BLVD
Practice Address - Street 2:SUITE 6 PMB 376
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7741
Practice Address - Country:US
Practice Address - Phone:907-301-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2036208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD20361Medicaid
AKMD20361Medicaid
AK164085Medicare PIN