Organization
EMPOWER MEDICAL AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYFANAE BRINKE ANP (FAMILY NURSE PRACTITIONER)
(907) 315-4042
Entity
Organization
Contact information
Practice address
1901 N HEMMER RD STE 211, PALMER, AK 99645-9690
(907) 315-4042
(907) 313-1417
Mailing address
1150 S COLONY WAY, STE 3 PMB 568, PALMER, AK 99645-6967
(907) 315-4042
(907) 313-1417
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1652161
—
AK
Enumeration date
05/16/2019
Last updated
02/01/2021
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