Provider Demographics
NPI:1760620611
Name:GRESS, SARA KRISTEEN (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:KRISTEEN
Last Name:GRESS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 GLACIER HIGHWAY
Mailing Address - Street 2:STE #218
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801
Mailing Address - Country:US
Mailing Address - Phone:907-789-1600
Mailing Address - Fax:907-789-2925
Practice Address - Street 1:8800 GLACIER HIGHWAY
Practice Address - Street 2:STE #218
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-789-1600
Practice Address - Fax:907-789-2925
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK342363L00000X
AK1068363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner