Individual
MS. MARY M. NEVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1060 GAFFNEY RD, FORT WAINWRIGHT, AK 99703-5002
(907) 353-4126
Mailing address
1650 COWLES ST, FAIRBANKS MEMORIAL HOSPITAL, FAIRBANKS, AK 99701-5998
(907) 458-5567
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
707
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4889
—
AK
Enumeration date
11/13/2006
Last updated
06/18/2018
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