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ISLAND BEHAVIORAL HEALTH LLC
NPI 1215508411
Nurse Practitioner - Psychiatric/Mental Health in Ketchikan, AK

Active since July 08, 2021
702 BAYVIEW ST APT B, KETCHIKAN, AK 99901(907) 617-8485 Get Directions Write a Review

NPPES record last updated: July 8, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Island Behavioral Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ISLAND BEHAVIORAL HEALTH LLC (NPI 1215508411) is a healthcare organization registered as a psychiatric/mental health in Ketchikan, Alaska and active in the NPI registry since July 2021. The organization lists Jennie R Wilks, Nurse Practitioner/owner, as its authorized official.

NPPES Registry Identity

NPI1215508411
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameISLAND BEHAVIORAL HEALTH LLC
Location Address702 BAYVIEW ST APT BKetchikan, AK 99901-6102
Mailing Address702 Bayview St Apt BKetchikan, AK 99901-6102 · (907) 617-8485
Phone(907) 617-8485
Organization SubpartNo
Authorized OfficialJennie R WilksNurse Practitioner/owner · (907) 617-8485
Enumeration DateJuly 8, 2021
NPPES CertifiedJuly 8, 2021
✔ NPI 1215508411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
702 BAYVIEW ST APT B, Ketchikan, AK 99901
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Other Identifiers 1

Medicaid1715763AK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Island Behavioral Health LLC's NPI number?

The NPI number for Island Behavioral Health LLC is 1215508411. It was assigned to this organization in the NPPES registry on July 8, 2021.

Where is Island Behavioral Health LLC located?

Island Behavioral Health LLC is located at 702 Bayview St Apt B, Ketchikan, AK 99901. The listed phone number is (907) 617-8485.

What is Island Behavioral Health LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Island Behavioral Health LLC was last updated on July 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.