Individual
LISA CARMEL FEYEREISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
269 MORGANS RD, ANIAK, AK 99557
(907) 675-4556
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
(907) 545-6100
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
03/29/2019
Last updated
03/29/2019
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