Individual
TABATHA SCHELLENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 212-7994
Mailing address
600 S STAMPER DR, WASILLA, AK 99654-7763
(907) 230-5681
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NURR29743
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
128108
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128108
ADVANCED NURSE PRACTITIONER LICENSE
AK
01
—
NURR29743
REGISTERED NURSE LICENSE
AK
Enumeration date
01/25/2018
Last updated
01/25/2018
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