Provider Demographics
NPI:1154568053
Name:JORDAN CREEK FAMILY HEALTH CARE
Entity type:Organization
Organization Name:JORDAN CREEK FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP-C
Authorized Official - Phone:907-789-1600
Mailing Address - Street 1:3032 VINTAGE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801
Mailing Address - Country:US
Mailing Address - Phone:907-789-1600
Mailing Address - Fax:907-789-2260
Practice Address - Street 1:3032 VINTAGE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-789-1600
Practice Address - Fax:907-789-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK882363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty