Individual
FE COMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1841 E 57TH AVE., 1841 E 57TH AVE., ANCHORAGE, AK 99507
(907) 222-5027
(907) 222-5027
Mailing address
1841 E 57TH AVE., 1841 E 57TH AVE., ANCHORAGE, AK 99507
(907) 222-5027
(907) 222-5027
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
100592
AK
376G00000X
Nursing Home Administrator
Primary
100592
AL
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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