Individual
JEANNE MOORE-KETTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11901 BUSINESS BLVD, SUITE 209, EAGLE RIVER, AK 99577-7701
(907) 694-6002
(907) 694-6022
Mailing address
11901 BUSINESS BLVD, SUITE 209, EAGLE RIVER, AK 99577-7701
(907) 694-6002
(907) 694-6022
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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