Individual
HEATHER POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 NOBLE ST, FAIRBANKS, AK 99701-4948
(907) 459-3500
(907) 459-3526
Mailing address
PO BOX 73720, FAIRBANKS, AK 99707-3720
(907) 459-3500
(907) 459-3526
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
160
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003938
—
AK
01
—
13916902
CAQH
—
01
—
160
ALASKA MEDICAL LICENSE
AK
Enumeration date
04/21/2016
Last updated
12/14/2017
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