Organization
EAGLE HEALTH ALASKA
Active
Other names
EAGLE HEALTH ALASKA, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN LYNN NINEFELDT MD (OWNER)
(907) 201-1102
Entity
Organization
Contact information
Practice address
2015 MERRILL FIELD DR, ANCHORAGE, AK 99501-4137
(907) 201-1102
Mailing address
PO BOX 671336, CHUGIAK, AK 99567-1336
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1652136
—
AK
Enumeration date
08/24/2020
Last updated
08/24/2020
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