Organization
SUMMIT CARE COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE MOORE KETTELL (CARE COORDINATOR)
(907) 764-5801
Entity
Organization
Contact information
Practice address
4411 W LAKE CIR, ANCHORAGE, AK 99502-4911
(907) 764-5801
Mailing address
4411 W LAKE CIR, ANCHORAGE, AK 99502-4911
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002066
—
AK
Enumeration date
04/21/2015
Last updated
04/21/2015
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