Basic Information
Provider Information
NPI: 1588774053
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YORK
FirstName: PATRICIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 196276
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995196276
CountryCode: US
TelephoneNumber: 9075656522
FaxNumber: 9075656592
Practice Location
Address1: 3200 PROVIDENCE DR
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995084615
CountryCode: US
TelephoneNumber: 9072613614
FaxNumber: 9072614896
Other Information
ProviderEnumerationDate: 08/30/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X7318AKY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home