Organization
MEDICAL NETWORK OF ALASKA, LLC
Active
Other names
Alpenglow Women's Health
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN RENEE BLOMKER (RCM)
(907) 864-4625
Entity
Organization
Contact information
Practice address
3122 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7255
(907) 357-9590
(907) 357-9593
Mailing address
3122 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7255
(907) 357-9590
(907) 357-9593
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2093387
STATE OF ALASKA BUSINESS LICENSE
AK
Enumeration date
10/07/2019
Last updated
11/02/2020
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