Organization
FAMILY DIABETES CLINIC
Active
Organization
FAMILY DIABETES CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L MICHALSKI ANP (OWNER)
(907) 677-3750
Entity
Organization
Contact information
Practice address
1407 W 31ST AVE, STE. 600, ANCHORAGE, AK 99503-3678
(907) 677-3750
(907) 677-3751
Mailing address
1407 W 31ST AVE, STE. 200, ANCHORAGE, AK 99503-3678
(907) 677-3750
(907) 677-3751
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
688
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MPG0391
—
AK
Enumeration date
07/28/2011
Last updated
11/18/2011
Update your record
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