Individual
KELLIE FONKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
302 RAILWAY AVE, SEWARD, AK 99664-0999
(907) 224-5257
Mailing address
PO BOX 1045, SEWARD, AK 99664-1045
(907) 224-5257
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
158813
AK
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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