Individual
MS. MARILYN ELAINE ATTLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1717 W COWLES ST, C.A.I.H.C., FAIRBANKS, AK 99701-5926
(907) 451-6682
(907) 459-3817
Mailing address
1717 W. COWLES ST., FAIRBANKS, AK 99701
(907) 451-6682
(907) 574-3922
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
320
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDA0401
—
AK
Enumeration date
10/27/2005
Last updated
07/14/2022
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