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Organization

EAGLE RIVER PAIN & WELLNESS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JESSICA JOYCE SPAYD ANP (OWNER)
(907) 622-4673
Entity
Organization

Contact information

Practice address
16425 BROOKS LOOP, EAGLE RIVER, AK 99577-8027
(907) 622-4673
(907) 622-4674
Mailing address
16425 BROOKS LOOP, EAGLE RIVER, AK 99577-8027
(907) 622-4673
(907) 622-4674

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
308947
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1584697
AK
Enumeration date
06/19/2013
Last updated
06/20/2014
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