Individual
CHRISTINE M BABCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
506 LAKE ST, KENAI, AK 99611-6937
(907) 714-4025
(907) 335-0064
Mailing address
506 LAKE ST, KENAI, AK 99611-6937
(907) 714-4025
(907) 335-0064
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
175
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255528733
NPI GROUP NUMBER
AK
01
—
152261
MEDICARE GROUP NUMBER
AK
01
—
162271
MEDICARE
—
01
—
175
ALASKA LICENSE #
AK
01
—
920077523
TAX ID
—
05
—
MDG830
—
AK
05
—
NP39991
—
AK
Enumeration date
09/19/2005
Last updated
03/07/2023
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