Individual
CAROL INDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 19TH AVE, FAIRBANKS, AK 99701-5903
(907) 451-6682
Mailing address
297 SNOWY OWL LN, FAIRBANKS, AK 99712-1243
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN 12785
AK
Other
Enumeration date
06/17/2012
Last updated
06/17/2012
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