Provider Demographics
NPI:1740661677
Name:KEIPER, ERIN ELIZABETH (APRN, CNM)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:KEIPER
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CNM
Mailing Address - Street 1:2054 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-7316
Mailing Address - Country:US
Mailing Address - Phone:907-456-3719
Mailing Address - Fax:907-456-1511
Practice Address - Street 1:2054 30TH AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7316
Practice Address - Country:US
Practice Address - Phone:907-456-3719
Practice Address - Fax:907-456-1511
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100320363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology