Individual
KIM I LORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
205 W FAIRVIEW AVE, HOMER, AK 99603-7032
(907) 435-0555
(844) 274-6970
Mailing address
205 W FAIRVIEW AVE, HOMER, AK 99603-7032
(907) 435-0555
(844) 274-6970
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2107
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1571285
—
AK
Enumeration date
01/07/2011
Last updated
01/24/2020
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