Provider Demographics
NPI:1609949817
Name:DOWELL, JILL KRISTINE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:KRISTINE
Last Name:DOWELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 W SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-5327
Mailing Address - Country:US
Mailing Address - Phone:907-376-2411
Mailing Address - Fax:907-352-3373
Practice Address - Street 1:1363 W SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-5327
Practice Address - Country:US
Practice Address - Phone:907-376-2411
Practice Address - Fax:907-352-3373
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006203363LP0808X
AK1270363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP30006203OtherARNP
WARN00122578OtherREGISTERED NURSE
AK1270OtherANP
WA9635277Medicaid
AK33608OtherRN
WAMD0934186OtherDEA
AK1270OtherANP
WAQ10981Medicare UPIN