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Organization
GLACIER BAY MEDICAL AND DIABETES CARE CENTER LLC
Active
Organization
GLACIER BAY MEDICAL AND DIABETES CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADRIENNE JOHNSON MSN, APRN, NP-C (OWNER/MANAGING MEMBER)
(907) 952-2296
Entity
Organization
Contact information
Practice address
1200 AIRPORT HEIGHTS DR STE 240, ANCHORAGE, AK 99508-2970
(907) 290-4666
(907) 921-5151
Mailing address
5598 KENAI FJORDS LOOP, ANCHORAGE, AK 99502-4047
(907) 290-4666
(907) 921-5151
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/28/2019
Last updated
10/21/2024
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