Provider Demographics
NPI:1063604957
Name:SPIEKER, IRENE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:SPIEKER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:RENA
Other - Middle Name:
Other - Last Name:SPIEKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4050 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE #204B WOMENS HEALTHCARE CENTER
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504
Mailing Address - Country:US
Mailing Address - Phone:907-929-9586
Mailing Address - Fax:907-929-3836
Practice Address - Street 1:4050 LAKE OTIS PKWY
Practice Address - Street 2:SUITE #204B WOMENS HEALTHCARE CENTER
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504
Practice Address - Country:US
Practice Address - Phone:907-929-9586
Practice Address - Fax:907-929-3836
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKANP0136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner