Individual
ELLEN L. KANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 YUKON CIR., WASILLA, AK 99654-9702
(907) 357-0458
(907) 357-0468
Mailing address
PO BOX 870458, WASILLA, AK 99687-0458
(907) 357-0458
(907) 357-0468
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CM7686
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM7686
—
AK
05
—
CMG768
—
AK
Enumeration date
03/26/2007
Last updated
07/08/2007
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