Provider Demographics
NPI:1902292386
Name:WHITMAN, ZAN MICHAEL (ARNP)
Entity Type:Individual
Prefix:
First Name:ZAN
Middle Name:MICHAEL
Last Name:WHITMAN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 770870
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-0870
Mailing Address - Country:US
Mailing Address - Phone:907-726-0378
Mailing Address - Fax:907-726-0374
Practice Address - Street 1:12812 OLD GLENN HWY STE C4
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7002
Practice Address - Country:US
Practice Address - Phone:907-726-0378
Practice Address - Fax:907-726-0374
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-12
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK102761363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health