Organization
GLACIER PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYELLEN AROVOLD (ADVANCED NURSE PRACTIONER)
(907) 586-1542
Entity
Organization
Contact information
Practice address
1600 GLACIER AVE, JUNEAU, AK 99801-1430
(907) 586-1542
(907) 586-1849
Mailing address
1600 GLACIER AVE, JUNEAU, AK 99801-1430
(907) 586-1542
(907) 586-1849
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
17
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD14482
—
AK
05
—
MD3544
—
AK
05
—
MD52881
—
AK
05
—
NP1539
—
AK
Enumeration date
02/12/2009
Last updated
02/12/2009
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