Provider Demographics
NPI:1427370329
Name:ALASKA HEALTH CARE CLINIC, INC.
Entity Type:Organization
Organization Name:ALASKA HEALTH CARE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MELICAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:907-279-3500
Mailing Address - Street 1:3600 MINNESOTA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3675
Mailing Address - Country:US
Mailing Address - Phone:907-279-3500
Mailing Address - Fax:907-258-0153
Practice Address - Street 1:3600 MINNESOTA DR
Practice Address - Street 2:SUITE B
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3675
Practice Address - Country:US
Practice Address - Phone:907-279-3500
Practice Address - Fax:907-258-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty