Individual provider · Type 1 NPI
Elaine Ponchione, ANP, RN, PSY. A.
Psychiatric/Mental Health Nurse Practitioner · Fairbanks, AK
NPI number
1720162332
Active
Practice location
250 Cushman St Ste 3C
Fairbanks, AK 99701-4665
Fax (907) 455-7803
Mailing address
250 Cushman St, Suite 3C
Fairbanks, AK 99701-4640
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counseling Psychologist | 103TC1900X | 491 (AK) |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 4018 (AK) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 1045 (AK) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1720162332
Elaine Ponchione, ANP, RN, PSY. A.'s National Provider Identifier is 1720162332, issued on Oct 24, 2006. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fairbanks, AK. The record was last updated on Nov 14, 2011.