Individual
ABIGAIL L GRANATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4100 LAKE OTIS PKWY, SUITE 320, ANCHORAGE, AK 99508-5229
(907) 563-4810
(907) 563-4811
Mailing address
4315 DIPLOMACY DR, ANCHORAGE, AK 99508-5926
(907) 563-2662
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1098
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1597361
—
AK
Enumeration date
07/29/2013
Last updated
04/24/2017
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