Provider Demographics
NPI:1295849446
Name:MAHER, CECELIA P (ANP)
Entity Type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:P
Last Name:MAHER
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 1:18128 FISH HATCHERY RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-9208
Mailing Address - Country:US
Mailing Address - Phone:907-854-5439
Mailing Address - Fax:
Practice Address - Street 1:724 POSTAL SERVICE LOOP
Practice Address - Street 2:BOX 7499
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99505-5001
Practice Address - Country:US
Practice Address - Phone:907-384-0830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK697363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health