Individual
KELLY EGGLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BACHLOR OF ARTS ED.
Contact information
Practice address
764 ADVENTURE ROAD, FAIRBANKS, AK 99712
(907) 460-1414
(907) 488-2652
Mailing address
PO BOX 56597, NORTH POLE, AK 99705
(907) 460-1414
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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