Provider Demographics
NPI:1609957349
Name:NORTHERN NURSING SERVICES, INC.
Entity Type:Organization
Organization Name:NORTHERN NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:NELL
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, ANP
Authorized Official - Phone:907-260-9027
Mailing Address - Street 1:PO BOX 4267
Mailing Address - Street 2:36121 MAYONI STREET
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-4267
Mailing Address - Country:US
Mailing Address - Phone:907-260-9027
Mailing Address - Fax:907-260-6905
Practice Address - Street 1:36121 MAYONI STREET
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-4267
Practice Address - Country:US
Practice Address - Phone:907-260-9027
Practice Address - Fax:907-260-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK438367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP04382Medicaid