Provider Demographics
NPI:1700093200
Name:NAUMAN, ABIGAIL BEVERLY
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:BEVERLY
Last Name:NAUMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:BEVERLY NAUMAN
Other - Last Name:VALENTINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:540 W INTL AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1105
Mailing Address - Country:US
Mailing Address - Phone:907-564-7415
Mailing Address - Fax:
Practice Address - Street 1:540 W INTL AIRPORT RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1105
Practice Address - Country:US
Practice Address - Phone:907-564-7415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM7583Medicaid