Provider Demographics
NPI:1447415419
Name:ASTER, PRISCILLA P
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:P
Last Name:ASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 BARROW ST STE 404
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3643
Mailing Address - Country:US
Mailing Address - Phone:907-258-3498
Mailing Address - Fax:907-279-0171
Practice Address - Street 1:44539 STERLING HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7938
Practice Address - Country:US
Practice Address - Phone:907-262-9400
Practice Address - Fax:907-262-9422
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM1447Medicaid