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Individual

KENDRA DRISDOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
20435 GRANITE PARK CIR, EAGLE RIVER, AK 99577-8852
(907) 744-1154
Mailing address
5981 HALIBUT CT, UNIT A, JBER, AK 99506-3620
(907) 782-9284

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
112573
AK
164W00000X
Licensed Practical Nurse
7099
AK

Other

Enumeration date
08/04/2014
Last updated
12/21/2018
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