Individual
KIMBERLY JOY KINNEBREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12350 INDUSTRY WAY STE 110, ANCHORAGE, AK 99515-4301
(907) 206-9114
(907) 206-7009
Mailing address
12350 INDUSTRY WAY STE 110, ANCHORAGE, AK 99515-4301
(907) 206-9114
(907) 206-7009
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60953898
WA
363AM0700X
Medical Physician Assistant
Primary
408
AK
Other
Enumeration date
06/28/2006
Last updated
05/25/2022
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