Individual
ANNA A. BOUTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
247 N FIREWEED ST STE A, SOLDOTNA, AK 99669-7593
(907) 262-8597
(907) 262-6516
Mailing address
247 N FIREWEED ST STE A, SOLDOTNA, AK 99669-7593
(907) 252-9875
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1158
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE1671
RAILROAD MEDICARE
AK
05
—
NP01136
—
AK
Enumeration date
06/10/2010
Last updated
07/22/2020
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