Individual
MS. KAYLEIGH DAVIS DEFOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 451-6682
Mailing address
PO BOX 94429, SEATTLE, WA 98124-6729
(907) 451-6682
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-04256
NC
Other
Enumeration date
05/29/2013
Last updated
04/15/2021
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