Individual
MRS. BERNADETTE BOJORGE BAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6821 W KNOX DR, WASILLA, AK 99654-9293
(907) 373-0821
Mailing address
6821 W KNOX DR, WASILLA, AK 99654-9293
(907) 373-0821
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28683
AK
163WP2201X
Ambulatory Care Registered Nurse
Primary
28683
AK
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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