Individual
MRS. KYMBERLI RAYE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3841 PIPER ST, SUITE T100, ANCHORAGE, AK 99508-4624
(907) 561-3211
(907) 562-7547
Mailing address
3841 PIPER ST, SUITE T100, ANCHORAGE, AK 99508-4624
(907) 561-3211
(907) 562-7547
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
NP-586A
ID
363LF0000X
Family Nurse Practitioner
Primary
1073
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147885
BLUE SHIELD
—
05
—
1022256
—
AK
05
—
806735600
—
ID
Enumeration date
06/17/2005
Last updated
10/29/2013
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