Individual
ERICK BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7169 FAIRWEATHER PARK LOOP, ANCHORAGE, AK 99518-2277
(251) 802-5968
Mailing address
7169 FAIRWEATHER PARK LOOP, ANCHORAGE, AK 99518-2277
(251) 802-5968
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
30814
AK
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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