Individual
LAURIE ELIZABETH FENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
ALASKA NATIVE MEDICAL CENTER, 4315 DIPLOMACY DRIVE, ANCHORAGE, AK 99508
(907) 729-1070
Mailing address
8505 SKYHILLS DR, ANCHORAGE, AK 99502-3993
(512) 800-0391
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0050-00974
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
681462
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287667401
—
TX
Enumeration date
04/10/2007
Last updated
07/10/2019
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