Individual
MS. LISA ANN FENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD LD
Contact information
Practice address
3245 HOSPITAL DR, SEARHC, JUNEAU, AK 99801-7809
(907) 463-4040
(907) 463-4673
Mailing address
222 TONGASS DRIVE, SEARHC, SITKA, AK 99835
(907) 966-2411
(907) 966-8300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
108
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DT2342
—
AK
Enumeration date
02/26/2007
Last updated
06/26/2009
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