Individual
LORRAINE FULLBRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18606 OLD GLENN HIGHWAY, CHUGIAK, AK 99567
(907) 688-0282
Mailing address
PO BOX 671750, CHUGIAK, AK 99567-1750
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CM6474
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM6474
—
AK
Enumeration date
04/11/2007
Last updated
07/08/2007
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