| Golden Heart Health & Wellness | |
|
424 Henderson Rd S Unit B Fairbanks AK 99709-2415 | |
| (907) 290-8430 | |
| Not Available |
| Full Name | Golden Heart Health & Wellness |
|---|---|
| Speciality | Family Medicine |
| Location | 424 Henderson Rd S Unit B, Fairbanks, Alaska |
| Authorized Official Name and Position | Caroline Hutto (NURSE PRACTITIONER) |
| Authorized Official Contact | 9072908430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Heart Health & Wellness 424 Henderson Rd S Unit B Fairbanks AK 99709-2415 Ph: () - | Golden Heart Health & Wellness 424 Henderson Rd S Unit B Fairbanks AK 99709-2415 Ph: (907) 290-8430 |
| NPI Number | 1447986955 |
|---|---|
| Provider Enumeration Date | 07/27/2022 |
| Last Update Date | 09/22/2022 |
| Medicare PECOS PAC ID | 0042695322 |
|---|---|
| Medicare Enrollment ID | O20220922002648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447986955 | NPI | - | NPPES |
| 158137 | Other | AK | STATE OF ALASKA LICENSE |
| 128999 | Other | AK | STATE OF ALASKA LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 367A00000X | Advanced Practice Midwife | (* (Not Available)) | Secondary |
| Provider Name | Caroline Tautz Hutto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346754207 PECOS PAC ID: 1557778792 Enrollment ID: I20210414001976 |
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