Provider Demographics
NPI:1841337334
Name:BAYER, NANCY PRUDENCE (ANP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:PRUDENCE
Last Name:BAYER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 755580
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99775-5580
Mailing Address - Country:US
Mailing Address - Phone:907-474-7043
Mailing Address - Fax:
Practice Address - Street 1:612 NORTH CHANDALAR AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99775-5580
Practice Address - Country:US
Practice Address - Phone:907-474-7043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKP27006Medicare UPIN