Individual
KRYSTOFER CERYN FENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7500
Mailing address
150 N WILLOW ST, KENAI, AK 99611-9121
(907) 335-7500
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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