Provider Demographics
NPI:1982389912
Name:BENDER, MICHELLE JEAN (DNP, CRNA)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JEAN
Last Name:BENDER
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11116 JUNE AGNES CIR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8196
Mailing Address - Country:US
Mailing Address - Phone:309-530-0449
Mailing Address - Fax:
Practice Address - Street 1:3300 PROVIDENCE DR STE 207
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4620
Practice Address - Country:US
Practice Address - Phone:907-279-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK240807367500000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1757694Medicaid