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Organization
GOLD STAR LONGEVITY & WELLNESS LLC
Active
Organization
GOLD STAR LONGEVITY & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL SCOTT PIERCE MD (OWNER, M.D.)
(907) 457-9420
Entity
Organization
Contact information
Practice address
751 OLD RICHARDSON HWY STE 200, FAIRBANKS, AK 99701-7805
(907) 457-9420
(907) 457-1098
Mailing address
751 OLD RICHARDSON HWY STE 200, FAIRBANKS, AK 99701-7805
(907) 457-9420
(907) 457-1098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LC1500X
Community Health Nurse Practitioner
—
NULL
363LC1500X
Community Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
09/24/2018
Last updated
05/11/2021
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