Provider Demographics
NPI:1942991096
Name:HARPER, BEVERLY (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:J
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 112153
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-2153
Mailing Address - Country:US
Mailing Address - Phone:907-244-3071
Mailing Address - Fax:907-278-2224
Practice Address - Street 1:529 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2207
Practice Address - Country:US
Practice Address - Phone:907-276-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKDOPD203156FX1800X
AK1124681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical