Individual
JENNIFER ANNE FAYETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3851 PIPER ST STE U462, ANCHORAGE, AK 99508-6905
(907) 562-6262
(907) 562-6267
Mailing address
3851 PIPER ST STE U462, ANCHORAGE, AK 99508-6905
(907) 562-6262
(907) 562-6267
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PADA1232
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13976534
CAQH
—
05
—
1627131
—
AK
Enumeration date
12/19/2014
Last updated
12/11/2024
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