Individual
KRISTINA LOUISE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4100 LAKE OTIS PKWY STE 320, ANCHORAGE, AK 99508-5231
(907) 563-4810
(907) 563-4811
Mailing address
4100 LAKE OTIS PKWY STE 320, ANCHORAGE, AK 99508-5231
(907) 563-4810
(907) 563-4811
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
204589
AK
Other
Enumeration date
06/02/2020
Last updated
10/11/2023
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