Individual
NICOLE E RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, CDCI
Contact information
Practice address
4000 LAUREL ST, ANCHORAGE, AK 99508-5333
(907) 729-6300
(907) 729-6341
Mailing address
4000 LAUREL ST, ANCHORAGE, AK 99508-5333
(907) 729-6300
(907) 729-6341
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4129
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43762
BLUE CROSS
AK
Enumeration date
05/14/2019
Last updated
05/14/2019
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