Individual
ELLEN HOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 ABBOTT RD, ANCHORAGE, AK 99507-3443
(907) 561-3313
(907) 561-3315
Mailing address
1750 ABBOTT RD, ANCHORAGE, AK 99507-3443
(907) 561-3313
(907) 561-3315
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
920101736
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG736
—
AK
Enumeration date
05/11/2011
Last updated
05/11/2011
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