# BOREALIS LIFE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700591831
- **Authorized official:** BRITNI STICKLE (PRACTICE MANAGER)
- **Authorized official phone:** (907) 206-4689

## Contact information

- **Practice address:** 2501 E 42ND AVE, ANCHORAGE, AK 99508-5369
- **Practice address phone:** (907) 206-4689
- **Practice address fax:** (907) 206-7426
- **Mailing address:** 2501 E 42ND AVE, ANCHORAGE, AK 99508-5369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2023
- **Last updated:** 05/11/2023