Provider Demographics
NPI:1982301073
Name:ALASKA NEURODIAGNOSTICS SPECIALISTS LLC
Entity Type:Organization
Organization Name:ALASKA NEURODIAGNOSTICS SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARRA
Authorized Official - Middle Name:RACHEL
Authorized Official - Last Name:PAULSEN
Authorized Official - Suffix:
Authorized Official - Credentials:R EEG T
Authorized Official - Phone:907-982-3114
Mailing Address - Street 1:911 W 8TH AVE SUITE 101 BOX 38
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501
Mailing Address - Country:US
Mailing Address - Phone:907-982-3114
Mailing Address - Fax:
Practice Address - Street 1:911 W 8TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3340
Practice Address - Country:US
Practice Address - Phone:907-982-3114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Single Specialty